MEDICARE: REHAAN AKBAR

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	122300000X	Dentist	019032334	IL

General Provider Information

NPI Number	:	1447806849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REHAAN AKBAR

Provider Business Mailing Address
First Line	:	1490 DOUGLAS RD
Second Line	:
City	:	OSWEGO
State	:	IL
Zip	:	60543-5106
Country	:	US
Telephone Number	:	331-999-3619
Fax Number	:

Provider Business Practice Location Address
First Line	:	1490 DOUGLAS RD
Second Line	:
City	:	OSWEGO
State	:	IL
Zip	:	60543-5106
Country	:	US
Telephone Number	:	331-999-3619
Fax Number	:

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

Provider Enumeration Date	:	08/13/2019
Last Update Date	:	08/13/2019

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Directions to “ REHAAN AKBAR ” Practice Location

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