Individual provider Active NPI

Asad Farooq, DMD

  • Dentist
  • Willowbrook, IL
National Provider Identifier
1750015210
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019034637 Issued in IL
Practice address
6300 Kingery Hwy Ste 216
Willowbrook, IL 60527-2254
Phone
(630) 323-5333
NPI assigned
Jul 12, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019034637 IL Primary

Addresses

Primary practice location

6300 Kingery Hwy Ste 216
Willowbrook, IL 60527-2254

Mailing address

6300 Kingery Hwy Ste 216
Willowbrook, IL 60527-2254
Phone (630) 323-5333

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

LicenseStateTypeSpecialty
019034637ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mariusz Borowicz DDS PC Dentist CurrentSince Sep 15, 2024 Accepting new patients
Dentists of Hinsdale Lake General Practice PastSince Sep 15, 2024 Accepting new patients

Locations

6300 Kingery Hwy
Ste 216
Willowbrook, IL 60527
Phone (630) 323-5333

Organizations & group practices 2

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1750015210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 KINGERY HWY STE 216",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272254",
            "telephone_number": "630-323-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 KINGERY HWY STE 216",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272254",
            "telephone_number": "630-323-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAROOQ",
        "first_name": "ASAD",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-12",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019034637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.