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General NPI Number Information
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NPI Number | 1174449102
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Entity Type | Organization
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Legal Business Name | TALA ELFAKI DMD LLC
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Dates
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Enumeration Date | 06/24/2026
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Last Update Date | 06/24/2026
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Provider Practice Location Address
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Address Line | 2604 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60647-5235
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Country | US
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Telephone | 773-252-0033
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 ROSE DR
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City | SYCAMORE
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State | IL
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Zip | 60178-9506
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Country | US
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Telephone | 815-981-0493
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Fax |
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Authorized Official
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Title or Position | DMD
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Name | TALA ELFAKI
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Credential | DMD
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Telephone | 815-981-0493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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