MEDICARE: DR. CHRISTINE NIKNAM LEILABADI DMD

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	019.036980	IL
2	122300000X	Dentist	019.036980	IL

General Provider Information

NPI Number	:	1376474163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE NIKNAM LEILABADI DMD

Provider Business Mailing Address
First Line	:	801 JEFFERSON ST
Second Line	:
City	:	HINSDALE
State	:	IL
Zip	:	60521-3624
Country	:	US
Telephone Number	:	206-303-7821
Fax Number	:

Provider Business Practice Location Address
First Line	:	6317 FAIRVIEW AVE STE 6
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-2804
Country	:	US
Telephone Number	:	630-496-7005
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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