Healthcare Provider Details

I. General information

NPI: 1790646206
Provider Name (Legal Business Name): AVI SINGH SAHI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17727 HALSTED ST
HOMEWOOD IL
60430-2009
US

IV. Provider business mailing address

10219 CHERRYWOOD LN
MUNSTER IN
46321-5123
US

V. Phone/Fax

Practice location:
  • Phone: 708-816-9037
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12014919A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.036626
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: