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NPI Code Detail

MEDICARE: LUBNA KADIR DDS PC

MEDICARE: LUBNA KADIR DDS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center019.029587IL

General Provider Information

NPI Number : 1023429800
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUBNA KADIR DDS PC
Provider Business Mailing Address
First Line : 1684 W PRESCOTT PL
Second Line :
City : ADDISON
State : IL
Zip : 60101-1863
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3190 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-5845
Country : US
Telephone Number : 773-267-9777
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : LUBNA KADIR III
Credential :
Telephone Number : 484-626-2185
Provider Enumeration Date : 05/14/2014
Last Update Date : 05/14/2014

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