Active NPI
Syed Nawaz
- General Practice Dentistry
- Burr Ridge, IL
National Provider Identifier
1417547829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019.032491
- Practice address
- 917 Prairie Ridge CT
Burr Ridge, IL 60527-7183 - Phone
- (630) 321-9490
- NPI assigned
- Jan 20, 2021
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.032491 | IL | Primary |
Addresses
Primary practice location
917 Prairie Ridge CT
Burr Ridge, IL 60527-7183
Mailing address
917 Prairie Ridge CT
Burr Ridge, IL 60527-7183
Phone (630) 321-9490
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 |
|---|---|---|---|
| 019.032491 | IL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611100800000",
"number": "1417547829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "917 PRAIRIE RIDGE CT",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605277183",
"telephone_number": "630-321-9490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "917 PRAIRIE RIDGE CT",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605277183",
"telephone_number": "630-321-9490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAWAZ",
"first_name": "SYED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-20",
"last_updated": "2021-01-20",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.032491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burr Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.