Healthcare Provider Details

I. General information

NPI: 1003536269
Provider Name (Legal Business Name): DR. TAWFIK ABDUL DAYEM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 S MAIN ST STE 241
NAPERVILLE IL
60540-5377
US

IV. Provider business mailing address

9006 DEL PRADO DR APT 2N
PALOS HILLS IL
60465-5000
US

V. Phone/Fax

Practice location:
  • Phone: 630-848-2010
  • Fax:
Mailing address:
  • Phone: 312-774-2585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019.033762
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN1859908
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2026013015
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: