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General NPI Number Information
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NPI Number | 1346810108
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Entity Type | Individual
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Provider Name | NAIM SHUAIPAJ DMD
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Gender | Male
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 11808 S PULASKI RD
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City | ALSIP
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State | IL
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Zip | 60803-1608
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Country | US
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Telephone | 708-489-6222
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Fax |
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Provider Business Mailing Address
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Address Line | 13800 SKENDER CT
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City | HOMER GLEN
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State | IL
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Zip | 60491-7219
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Country | US
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Telephone | 630-432-3825
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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 | 019.033111
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License Number State | IL
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