Gamal S Naguib, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

019014756 Issued in IL

Practice address

302 E Saint Charles Rd
Villa Park, IL 60181-2420

Phone

(630) 936-4410

Fax

(630) 563-9174

NPI assigned

Jul 14, 2005

Reactivated

Mar 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Quantum Anesthesia Services LLC

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
  • NPI 1033546833
  NPD (past)

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124027990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8135 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607142828",
            "telephone_number": "847-967-8098",
            "fax_number": "847-967-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E SAINT CHARLES RD",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812420",
            "telephone_number": "630-936-4410",
            "fax_number": "630-563-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGUIB",
        "first_name": "GAMAL",
        "middle_name": "S",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2022-07-21",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": "019014756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ILLINOIS",
            "identifier": "33060",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019014756",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivian Moreno
• Jaime Boudros Mossman
• Katherine Mucerino
• Emily Marie Muzzy, OTR/L
• Amanda C Nagle
• Cynthia Lynn Neenan Baranoski
• Malinka Nenova, PHARM. D.
• Kelly Nesbitt, OTR/L
• New Creation Home Care Services,Inc
• New Creation Home Care Services,Inc

• Oral & Maxillofacial Surgery (D.M.D.) in Villa Park, IL
• Providers in Villa Park, IL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.