Healthcare Provider Details

I. General information

NPI: 1184131500
Provider Name (Legal Business Name): DR. HATEM M GELANI SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

552 S WASHINGTON ST STE 220
NAPERVILLE IL
60540-6670
US

IV. Provider business mailing address

3203 111TH ST APT 107
NAPERVILLE IL
60564-0006
US

V. Phone/Fax

Practice location:
  • Phone: 231-737-0037
  • Fax: 231-760-5497
Mailing address:
  • Phone: 617-380-8663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number019031735
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: