Reyam Hisham Mobder Al Janaby, DMD
Individual provider Active NPI Dentist · Glen Ellyn, IL
NPI 1396571337 · NPPES record last updated Jan 11, 2026
Key facts
- NPI
- 1396571337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019.035314 (IL)
- Practice address
- 904 Roosevelt Rd
Glen Ellyn, IL 60137-7829 - Phone
- (630) 469-4500
- NPI assigned
- Sep 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.035314 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baker Hill Dental PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.035314 | IL | Yes |
Addresses
Primary practice location
904 Roosevelt Rd
Glen Ellyn, IL 60137-7829
Mailing address
904 Roosevelt Rd
Glen Ellyn, IL 60137-7829
Phone (630) 469-4500
Other providers in Glen Ellyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.