Individual provider Active NPI

Hassan Souhail Ibrahim Sadik, DDS

  • Dentist
  • Roselle, IL
National Provider Identifier
1962374595
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.036261 Issued in IL
Practice address
1530 Lake St
Roselle, IL 60172-3330
Phone
(630) 529-0900
NPI assigned
Sep 23, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.036261 IL Primary

Addresses

Primary practice location

1530 Lake St
Roselle, IL 60172-3330

Mailing address

545 N McClurg CT Unit 3106
Chicago, IL 60611-3950
Phone (646) 954-0656

Other practice location 1

208 N Dunton Ave
Arlington Heights, IL 60004-5958
Phone (847) 463-3670

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
019.036261ILMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1962374595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 N MCCLURG CT UNIT 3106",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113950",
            "telephone_number": "646-954-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 LAKE ST",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601723330",
            "telephone_number": "630-529-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 N Dunton Ave",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600045958",
            "country_code": "US",
            "telephone_number": "847-463-3670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM SADIK",
        "first_name": "HASSAN SOUHAIL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.036261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.