MEDICARE: DR. SHEHBAZ SHAREEF D.M.D

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	019.028816	IL

General Provider Information

NPI Number	:	1225317209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEHBAZ SHAREEF D.M.D

Provider Business Mailing Address
First Line	:	1185 DUNDEE AVE
Second Line	:	SUITE A1
City	:	ELGIN
State	:	IL
Zip	:	60120-2232
Country	:	US
Telephone Number	:	847-902-0963
Fax Number	:	847-488-9147

Provider Business Practice Location Address
First Line	:	1185 DUNDEE AVE
Second Line	:	SUITE A1
City	:	ELGIN
State	:	IL
Zip	:	60120-2232
Country	:	US
Telephone Number	:	847-902-0963
Fax Number	:	847-488-9147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2011
Last Update Date	:	08/09/2011

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