Healthcare Provider Details

I. General information

NPI: 1841115391
Provider Name (Legal Business Name): ISAM QURAISHI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3112 UNION AVE
STEGER IL
60475-1166
US

IV. Provider business mailing address

704 SPINDLETREE AVE
NAPERVILLE IL
60565-2876
US

V. Phone/Fax

Practice location:
  • Phone: 708-754-8090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019037456
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: