Healthcare Provider Details

I. General information

NPI: 1144147141
Provider Name (Legal Business Name): KENDAH ALZALAM DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12201 S HARLEM AVE
PALOS HEIGHTS IL
60463-1474
US

IV. Provider business mailing address

13050 RIDGEWOOD DR
PALOS PARK IL
60464-2514
US

V. Phone/Fax

Practice location:
  • Phone: 708-729-2300
  • Fax:
Mailing address:
  • Phone: 708-945-0801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number319.025395
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: