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General NPI Number Information
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NPI Number | 1336060482
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Entity Type | Individual
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Provider Name | FARAH ALI
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Gender | Female
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Dates
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Enumeration Date | 07/23/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 2442 SYCAMORE RD
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City | DEKALB
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State | IL
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Zip | 60115-2050
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Country | US
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Telephone | 815-748-2666
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Fax |
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Provider Business Mailing Address
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Address Line | 23 COUR MARQUIS
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City | PALOS HILLS
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State | IL
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Zip | 60465-2410
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Country | US
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Telephone | 872-212-1894
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019037341
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License Number State | IL
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