Active NPI
Sinan A Razzak, D.M.D,B.D.S
- Dentist
- Cicero, IL
National Provider Identifier
1295935369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 19027470
- Practice address
- 3020 S Cicero Ave
Cicero, IL 60804-3638 - Phone
- (708) 863-2000
- NPI assigned
- Jul 18, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 19027470 | IL | Primary |
Addresses
Primary practice location
3020 S Cicero Ave
Cicero, IL 60804-3638
Mailing address
3020 S Cicero Ave
Cicero, IL 60804-3638
Phone (708) 863-2000
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 |
|---|---|---|---|
| 19027470 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Braces Town PC | Past | Accepting new patients | |
| Image Dental LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Cicero, IL
- NPI 1063789584
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Cicero, IL
- NPI 1881169134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332633600000",
"number": "1295935369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 S CICERO AVE",
"city": "CICERO",
"state": "IL",
"postal_code": "608043638",
"telephone_number": "708-863-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 S CICERO AVE",
"city": "CICERO",
"state": "IL",
"postal_code": "608043638",
"telephone_number": "708-863-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAZZAK",
"first_name": "SINAN",
"middle_name": "A",
"credential": "D.M.D,B.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-18",
"last_updated": "2012-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "19027470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cicero, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.