Nader Chehel Amiran
Individual provider Active NPI Dentist · Burbank, IL
NPI 1700447174 · NPPES record last updated Jun 25, 2019
Key facts
- NPI
- 1700447174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019.032205 (IL)
- Practice address
- 5307 W 79TH St
Burbank, IL 60459-1403 - Phone
- (708) 424-5650
- NPI assigned
- Jun 25, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.032205 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nader Amiran DMD Inc. | Dentist | Current | Accepting new patients |
| True Dentistry | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.032205 | IL | Yes |
Addresses
Primary practice location
5307 W 79TH St
Burbank, IL 60459-1403
Mailing address
450 S Warren Ave
Palatine, IL 60074-6408
Phone (312) 912-3171
Other providers in Burbank, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.