Active NPI
Rusul Albazi
- General Practice Dentistry
- Chicago, IL
National Provider Identifier
1720816473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019035374
- Practice address
- 2620 N Halsted St
Chicago, IL 60614-7694 - Phone
- (312) 373-1117
- NPI assigned
- Jul 24, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019035374 | IL | |
| General Practice Dentistry | 1223G0001X | 019035374 | IL | Primary |
Addresses
Primary practice location
2620 N Halsted St
Chicago, IL 60614-7694
Mailing address
2620 N Halsted St
Chicago, IL 60614-7694
Phone (215) 596-9452
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 |
|---|---|---|---|
| 019035374 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mehr Dental Arts and Orthodontics, P.C | Dentist | Current | Accepting new patients |
Organizations & group practices 1
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": "1721779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1720816473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2620 N HALSTED ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606147694",
"telephone_number": "215-596-9452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 N HALSTED ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606147694",
"telephone_number": "312-373-1117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALBAZI",
"first_name": "RUSUL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-24",
"last_updated": "2024-07-24",
"certification_date": "2024-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019035374",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019035374",
"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 Jul 24, 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.