Healthcare Provider Details

I. General information

NPI: 1164725131
Provider Name (Legal Business Name): BEHZAD SANEI D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2010
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5821 DEMPSTER ST
MORTON GROVE IL
60053-3028
US

IV. Provider business mailing address

5821 DEMPSTER ST
MORTON GROVE IL
60053-3028
US

V. Phone/Fax

Practice location:
  • Phone: 847-581-1942
  • Fax: 847-581-1943
Mailing address:
  • Phone: 847-581-1942
  • Fax: 847-581-1943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.028529
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: