Active NPI
Faisel Shehadeh, DMD
- Dentist
- Crestwood, IL
National Provider Identifier
1336035153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.036162
- Practice address
- 13442 Cicero Ave
Crestwood, IL 60418-1430 - Phone
- (708) 393-4911
- NPI assigned
- Jun 17, 2025
- 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 | 019.036162 | IL | Primary |
Addresses
Primary practice location
13442 Cicero Ave
Crestwood, IL 60418-1430
Mailing address
28294 Ferry Rd Apt 269
Warrenville, IL 60555-4065
Phone (708) 267-6374
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 |
|---|---|---|---|
| 019.036162 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750118400000",
"number": "1336035153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28294 FERRY RD APT 269",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605554065",
"telephone_number": "708-267-6374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13442 CICERO AVE",
"city": "CRESTWOOD",
"state": "IL",
"postal_code": "604181430",
"telephone_number": "708-393-4911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEHADEH",
"first_name": "FAISEL",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-06-17",
"last_updated": "2025-06-17",
"certification_date": "2025-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.036162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.