Wisam Musa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019033348 Issued in IL

Practice address

1600 E 93Rd St
Chicago, IL 60617-3607

Phone

(773) 530-7550

Fax

(773) 530-0287

NPI assigned

Feb 19, 2019

Sex

Male

Sole proprietor

Yes

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fullerton Dental Island LLC

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1265285167
  NPD Authorized official

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1487110029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E 93RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173607",
            "telephone_number": "773-530-7550",
            "fax_number": "773-530-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSA",
        "first_name": "WISAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-19",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019033348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rekha Murthy, LCSW
• Vijay Murthy, MD, MBBS, MS, MCH
• Margo Elizabeth Murvay, LCSW
• Michael E Murzyn, D.D.S.
• Lana Musa
• Gabrielle M Musacchio, LCPC
• Alison Musaraca, RDN, LDN
• Jake Musashe, PA-C
• Brooke Musburger
• Mackenzie Musch, MS, RDN, LDN

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, 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 Nov 8, 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.

Verify at the official NPI Registry.