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General NPI Number Information
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NPI Number | 1720903479
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Entity Type | Individual
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Provider Name | REEM SHEBRAIN
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Gender | Female
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 18954 W NORTH WOODALE TRL
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City | LAKE VILLA
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State | IL
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Zip | 60046-1712
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Country | US
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Telephone | 847-530-8180
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Fax |
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Provider Business Mailing Address
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Address Line | 18954 W NORTH WOODALE TRL
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City | LAKE VILLA
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State | IL
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Zip | 60046-1712
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Country | US
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Telephone |
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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 | 019.037163
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6002301
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License Number State | WI
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