Individual provider Active NPI

Yasir Obaidi, DDS

  • General Practice Dentistry
  • Schaumburg, IL
National Provider Identifier
1689102865
Registry record updated Nov 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019031299 Issued in IL
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

Updated by the provider on Nov 24, 2024

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220901003157 IL Practitioner - Dentist 5395018469 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019031299ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Dental PLLC CurrentSince Sep 23, 2024 Accepting new patients
Erie Family Health Center Inc CurrentSince Sep 7, 2022 Accepting new patients
Erie Family Health Center, Inc CurrentSince Sep 7, 2022 Accepting new patients
Chicago Dental Society Foundation PastSince Oct 5, 2021 Accepting new patients
Blaibel Enterprise Inc. PastSince Jun 1, 2024 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.

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

Verify at the official NPI Registry.