MEDICARE: NOOR OBAISI, D.D.S., P.C.

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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1114885274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOOR OBAISI, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	2058 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-6412
Country	:	US
Telephone Number	:	217-314-0033
Fax Number	:

Provider Business Practice Location Address
First Line	:	2058 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-6412
Country	:	US
Telephone Number	:	217-314-0033
Fax Number	:

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	NOOR AMINAH OBAISI
Credential	:	DDS
Telephone Number	:	217-314-0033

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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