Active NPI
Halah Mohammed
- Dentist
- Chicago, IL
National Provider Identifier
1508550690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1508550690
- Practice address
- 676 N Michigan Ave Ste 3500
Chicago, IL 60611-2839 - Phone
- (718) 630-7000
- NPI assigned
- Jun 2, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 1508550690 | IL | Primary |
Addresses
Primary practice location
676 N Michigan Ave Ste 3500
Chicago, IL 60611-2839
Mailing address
610 Del Sol Dr Apt 716
San Diego, CA 92108-3024
Phone (858) 257-8095
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 |
|---|---|---|---|
| 1508550690 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723593600000",
"number": "1508550690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 DEL SOL DR APT 716",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083024",
"telephone_number": "858-257-8095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "676 N MICHIGAN AVE STE 3500",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112839",
"telephone_number": "718-630-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHAMMED",
"first_name": "HALAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-02",
"last_updated": "2024-08-14",
"certification_date": "2024-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "IL",
"license": "1508550690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.