Individual provider Active NPI

Abdalhameed Madwar

  • Dentist
  • Darien, IL
National Provider Identifier
1831688977
Registry record updated Apr 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.032798 Issued in IL
Practice address
801 Plainfield Rd
Darien, IL 60561-4286
Phone
(630) 323-4903
Fax
(630) 323-4909
NPI assigned
May 3, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.032798 IL Primary

Addresses

Primary practice location

801 Plainfield Rd
Darien, IL 60561-4286

Mailing address

4 Hampton CT
Burr Ridge, IL 60527-5760

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
019.032798ILMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650153600000",
    "number": "1831688977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HAMPTON CT",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PLAINFIELD RD",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605614286",
            "telephone_number": "630-323-4903",
            "fax_number": "630-323-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADWAR",
        "first_name": "ABDALHAMEED",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-03",
        "last_updated": "2022-04-17",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2022; 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.