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General NPI Number Information
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NPI Number | 1205354024
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Entity Type | Individual
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Provider Name | DR. AHMED Q A HAMDI
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Gender | Male
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 08/31/2017
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Provider Practice Location Address
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Address Line | 9312 SKOKIE BLVD
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City | SKOKIE
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State | IL
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Zip | 60077-1309
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Country | US
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Telephone | 847-673-3621
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Fax |
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Provider Business Mailing Address
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Address Line | 1412 WESLEY CT
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City | MUNDELEIN
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State | IL
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Zip | 60060-4109
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Country | US
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Telephone | 847-404-5742
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 019031375
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License Number State | IL
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