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NPI Code Detail

MEDICARE: DR. KAIS K RABADI DDS

MEDICARE: DR. KAIS K RABADI DDS
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
11223G0001XGeneral Practice Dentistry019-028297IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1019-028297OTHERILLICENSE

General Provider Information

NPI Number : 1033420302
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAIS K RABADI DDS
Provider Business Mailing Address
First Line : 4332 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2144
Country : US
Telephone Number : 773-754-3500
Fax Number : 773-754-3504
Provider Business Practice Location Address
First Line : 4332 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2144
Country : US
Telephone Number : 773-754-3500
Fax Number : 773-754-3504
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2010
Last Update Date : 07/01/2010

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Directions to “ DR. KAIS K RABADI DDS” Practice Location

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