MEDICARE: MOHAMMAD R EKHTERA, 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
1	1223G0001X	General Practice Dentistry	31901441	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205084456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOHAMMAD R EKHTERA, DDS. PC

Provider Business Mailing Address
First Line	:	1700 WASHINGTON AVE
Second Line	:
City	:	WILMETTE
State	:	IL
Zip	:	60091-2421
Country	:	US
Telephone Number	:	224-875-0343
Fax Number	:	872-203-9984

Provider Business Practice Location Address
First Line	:	3190 E. ELSTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-7129
Country	:	US
Telephone Number	:	773-564-9916
Fax Number	:	872-203-9984

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MOHAMMAD R EKHTERA
Credential	:	DDS
Telephone Number	:	224-875-0343

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	10/20/2025

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