Active NPI
Yasir Obaidi, DDS
- General Practice Dentistry
- Schaumburg, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019031299
- Practice address
- 1843 W Golf Rd
Schaumburg, IL 60194-1148 - Phone
- (847) 807-6024
- Fax
- (847) 807-6028
- NPI assigned
- May 31, 2017
- 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 | 019031299 | IL | Primary |
Addresses
Primary practice location
1843 W Golf Rd
Schaumburg, IL 60194-1148
Mailing address
2323 Grand Ave
Waukegan, IL 60085-3312
Phone (847) 666-2438
Other practice location 1
3469 Kirchoff Rd
Rolling Meadows, IL 60008-1842
Phone (847) 818-0088
Other practice location 2
1901 W Western Ave Ste B
South Bend, IN 46619-3570
Phone (574) 234-9033 ext. 4332
Other practice location 3
825 E Rollins Rd
Round Lake Beach, IL 60073-2244
Phone (224) 757-0050
Other practice location 4
2323 Grand Ave
Waukegan, IL 60085-3312
Phone (847) 666-3494
Other practice location 5
416 E Roosevelt Rd Ste 102
Wheaton, IL 60187-5589
Phone (630) 260-8530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019031299 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifetime Dental PLLC | Current | Accepting new patients | |
| Erie Family Health Center Inc | Current | Accepting new patients | |
| Erie Family Health Center, Inc | Current | Accepting new patients | |
| Chicago Dental Society Foundation | Past | Accepting new patients | |
| Blaibel Enterprise Inc. | Past | Accepting new patients |
Locations
1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381
1504 S Albany Ave
Chicago, IL 60623
1843 W Golf Rd
Schaumburg, IL 60194
Phone (847) 807-6024
2323 Grand Ave
Waukegan, IL 60085
Phone (847) 666-2427
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1760499545
-
- Dentist
- Schaumburg, IL
- NPI 1447087705
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1548062318
-
- Dentist
- Rolling Meadows, IL
- NPI 1609179811
-
- Dentist
- Wheaton, IL
- NPI 1194497081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732406400000",
"number": "1689102865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2323 GRAND AVE",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600853312",
"telephone_number": "847-666-2438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1843 W GOLF RD",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601941148",
"telephone_number": "847-807-6024",
"fax_number": "847-807-6028"
}
],
"practiceLocations": [
{
"address_1": "3469 Kirchoff Rd",
"address_purpose": "LOCATION",
"city": "Rolling Meadows",
"state": "IL",
"postal_code": "600081842",
"country_code": "US",
"telephone_number": "847-818-0088",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1901 W Western Ave Ste B",
"address_purpose": "LOCATION",
"city": "South Bend",
"state": "IN",
"postal_code": "466193570",
"country_code": "US",
"telephone_number": "574-234-9033 x4332",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "825 E Rollins Rd",
"address_purpose": "LOCATION",
"city": "Round Lake Beach",
"state": "IL",
"postal_code": "600732244",
"country_code": "US",
"telephone_number": "224-757-0050",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2323 Grand Ave",
"address_purpose": "LOCATION",
"city": "Waukegan",
"state": "IL",
"postal_code": "600853312",
"country_code": "US",
"telephone_number": "847-666-3494",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "416 E Roosevelt Rd Ste 102",
"address_purpose": "LOCATION",
"city": "Wheaton",
"state": "IL",
"postal_code": "601875589",
"country_code": "US",
"telephone_number": "630-260-8530",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OBAIDI",
"first_name": "YASIR",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-31",
"last_updated": "2024-11-24",
"certification_date": "2024-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019031299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.