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General NPI Number Information
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NPI Number | 1316321722
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Entity Type | Individual
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Provider Name | SYED REHMAN DMD
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Gender | Male
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 1300 S ELMHURST RD APT 212
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056
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Country | US
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Telephone | 847-915-2827
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 S ELMHURST RD APT 212
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-5284
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Country | US
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Telephone | 847-915-2827
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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 | 019030260
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019030260
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License Number State | IL
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