Healthcare Provider Details

I. General information

NPI: 1366376592
Provider Name (Legal Business Name): ADIL AZIZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10601 S WESTERN AVE # 4
CHICAGO IL
60643-3100
US

IV. Provider business mailing address

10601 S WESTERN AVE # 4
CHICAGO IL
60643-3100
US

V. Phone/Fax

Practice location:
  • Phone: 773-238-3200
  • Fax:
Mailing address:
  • Phone: 773-238-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.037167
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: