Basel M F Abozor

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019034595 Issued in IL

Practice address

140 W Roosevelt Rd
Villa Park, IL 60181-3504

Phone

(682) 847-5874

NPI assigned

Jun 9, 2021

Last updated

Dec 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701475200000",
    "number": "1316514003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W ROOSEVELT RD",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813504",
            "telephone_number": "682-847-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W ROOSEVELT RD",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601813504",
            "telephone_number": "682-847-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOZOR",
        "first_name": "BASEL",
        "middle_name": "M F",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-09",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019034595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A&M Healthcare Services LLC
• Accelerated Rehabilitation Centers LTD (Athletico Physical Therapy)
• Molly Ahitow
• Anush Ahmed, OTD, OTR/L
• Hussain Ali Neama Al Akam, DDS
• Fauwaz Alaswad, PHARMD

• General Practice Dentistry in Villa Park, IL
• Providers in Villa Park, 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 Dec 2, 2023; 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.