Healthcare Provider Details

I. General information

NPI: 1184503682
Provider Name (Legal Business Name): EVER DENTAL STUDIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MICHIGAN AVE STE 1901
CHICAGO IL
60602-3624
US

IV. Provider business mailing address

360 E SOUTH WATER ST APT 4906
CHICAGO IL
60601-4160
US

V. Phone/Fax

Practice location:
  • Phone: 630-209-8902
  • Fax:
Mailing address:
  • Phone: 630-209-8902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: RANEEM ALHAKIM
Title or Position: DR.
Credential:
Phone: 630-209-8902