MEDICARE: EKRAM KAMEL SAEED 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		IL

General Provider Information

NPI Number	:	1528289626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EKRAM KAMEL SAEED D.M.D.

Provider Business Mailing Address
First Line	:	3020 CHARLES ST
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-1758
Country	:	US
Telephone Number	:	815-399-5181
Fax Number	:	815-399-1721

Provider Business Practice Location Address
First Line	:	3020 CHARLES ST
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-1758
Country	:	US
Telephone Number	:	815-399-5181
Fax Number	:	815-399-1721

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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