Healthcare Provider Details

I. General information

NPI: 1548186174
Provider Name (Legal Business Name): AQIB MUHAMMAD SHAFI BDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 S MAIN ST STE 271
NAPERVILLE IL
60540-8044
US

IV. Provider business mailing address

55 S MAIN ST STE 271
NAPERVILLE IL
60540-8044
US

V. Phone/Fax

Practice location:
  • Phone: 630-848-6960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number021.003538
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: