MEDICARE: EKRAM K. SAEED, DMD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	019-023618	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1528289626	OTHER	IL	NPI

General Provider Information

NPI Number	:	1487098075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EKRAM K. SAEED, DMD, PC

Provider Business Mailing Address
First Line	:	3020 CHARLES ST
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-1758
Country	:	US
Telephone Number	:	815-399-5181
Fax Number	:	815-399-1721

Provider Business Practice Location Address
First Line	:	3020 CHARLES ST
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-1758
Country	:	US
Telephone Number	:	815-399-5181
Fax Number	:	815-399-1721

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. EKRAM K SAEED
Credential	:	DMD, PC
Telephone Number	:	815-399-5181

Provider Enumeration Date	:	04/25/2013
Last Update Date	:	04/25/2013

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