Active NPI
Mahmoud Abusaoud
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1225680432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019032237
- Practice address
- 6930 S Pulaski Rd
Chicago, IL 60629-4223 - Phone
- (773) 312-5178
- NPI assigned
- Jul 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019032237 | IL | Primary |
Addresses
Primary practice location
6930 S Pulaski Rd
Chicago, IL 60629-4223
Mailing address
9338 Pepperwood Dr
Orland Hills, IL 60487-5604
Phone (708) 407-1309
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019032237 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562630400000",
"number": "1225680432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9338 PEPPERWOOD DR",
"city": "ORLAND HILLS",
"state": "IL",
"postal_code": "604875604",
"telephone_number": "708-407-1309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6930 S PULASKI RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606294223",
"telephone_number": "773-312-5178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABUSAOUD",
"first_name": "MAHMOUD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-09",
"last_updated": "2019-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019032237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.