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General NPI Number Information
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NPI Number | 1427222645
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Entity Type | Organization
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Legal Business Name | NIDA A. MAROUF, D.M.D., LTD.
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 5787 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60659-4722
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Country | US
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Telephone | 773-293-0606
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Fax | 773-751-5237
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Provider Business Mailing Address
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Address Line | 2721 SUMMIT AVE
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-1325
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Country | US
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Telephone | 847-681-2229
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | DR. NIDA A. MAROUF
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Credential | D.M.D.
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Telephone | 773-293-0606
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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 | IL
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