Healthcare Provider Details

I. General information

NPI: 1619043502
Provider Name (Legal Business Name): ADEL N GAYED DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 N CENTRAL AVE
CHICAGO IL
60634
US

IV. Provider business mailing address

3305 N CENTRAL AVE
CHICAGO IL
60634
US

V. Phone/Fax

Practice location:
  • Phone: 773-282-4200
  • Fax: 773-282-9888
Mailing address:
  • Phone: 773-282-4200
  • Fax: 773-282-9888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number19A14845
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: