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General NPI Number Information
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NPI Number | 1871314690
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Entity Type | Individual
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Provider Name | NOOR ALSHAIKH DDS
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 2050 MARQUETTE RD STE 200
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City | PERU
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State | IL
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Zip | 61354-4000
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Country | US
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Telephone | 815-224-2355
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Fax |
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Provider Business Mailing Address
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Address Line | 3208 GLENLOCH PL
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-3476
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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 | 019.035556
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 021.003379
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License Number State | IL
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