Healthcare Provider Details

I. General information

NPI: 1124945183
Provider Name (Legal Business Name): ASCEND DENTAL ASHLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3540 N ASHLAND AVE
CHICAGO IL
60657-1314
US

IV. Provider business mailing address

3540 N ASHLAND AVE
CHICAGO IL
60657-1314
US

V. Phone/Fax

Practice location:
  • Phone: 312-755-8488
  • Fax: 312-755-8488
Mailing address:
  • Phone: 312-755-8488
  • Fax: 312-755-8488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SYED REHMAN
Title or Position: OWNER
Credential: DMD
Phone: 312-755-8488