Mohammed Adil Asim, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027367 Issued in IL

Practice address

4434 W Fullerton Ave
Chicago, IL 60639-1932

Phone

(773) 486-6500

Fax

(773) 486-6556

NPI assigned

Jun 5, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Mohammed Adil Asim Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1043412620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 W. NORTH AVE SUITE 400",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "60164",
            "telephone_number": "708-562-5100",
            "fax_number": "708-562-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4434 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391932",
            "telephone_number": "773-486-6500",
            "fax_number": "773-486-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASIM",
        "first_name": "MOHAMMED",
        "middle_name": "ADIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027367",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019027367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOHAMMED",
            "last_name": "ASIM",
            "middle_name": "ADIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Asian Human Services, Inc.
• Asian Human Services, Inc.
• Asian Village Dental Clinic
• Asian Village Medical Clinic PC
• Mehar Gani Asim, O.D.
• Angela Asimakopoulos, DNP
• Fotios Asimakopoulos, MD
• Georgios Nikolaos Asimis, MD
• Asj MD SC
• Ask Consultation and Support

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.