Individual provider Active NPI

Reama Srour, DMD

  • General Practice Dentistry
  • Oakbrook Terrace, IL
National Provider Identifier
1467075200
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019.032597 Issued in IL
Practice address
17W679 Roosevelt Rd
Oakbrook Terrace, IL 60181-3545
Phone
(630) 932-8400
NPI assigned
May 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.032597 IL Primary

Addresses

Primary practice location

17W679 Roosevelt Rd
Oakbrook Terrace, IL 60181-3545

Mailing address

13030 Dunmoor Dr
Lemont, IL 60439-2740
Phone (630) 215-3574

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

LicenseStateTypeSpecialty
019.032597ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1467075200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13030 DUNMOOR DR",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604392740",
            "telephone_number": "630-215-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17W679 ROOSEVELT RD",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813545",
            "telephone_number": "630-932-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SROUR",
        "first_name": "REAMA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.