Issa Sahouri

Primary specialty

DentistTaxonomy code 122300000X

License

019.035317 Issued in IL

Practice address

141 E Pershing Rd
Decatur, IL 62526-3213

Phone

(217) 877-6559

NPI assigned

Jul 8, 2024

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

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1669218798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10214 MULBERRY LN APT B",
            "city": "BRIDGEVIEW",
            "state": "IL",
            "postal_code": "604556017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E PERSHING RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263213",
            "telephone_number": "217-877-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHOURI",
        "first_name": "ISSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.035317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Franklin Rutherford III, DO
• Rachel Mae Ryan
• Jessica Marie Ryder, NP-C
• Steven James Rylander, DC
• Hamid Sagha, MD
• Britney N Sain
• Wendy E. Salefski, OTR/L CHT
• Neam Hamdan Saleh
• Stephen E Salisbury, PHARMD
• Matthew S Samuels, LPC

• Dentist in Decatur, IL
• Providers in Decatur, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.