MEDICARE: DR. FAISEL ABDULHAMID ASHTEWI

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	1223P0700X	Prosthodontics	019.030521	IL

General Provider Information

NPI Number	:	1801100391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAISEL ABDULHAMID ASHTEWI

Provider Business Mailing Address
First Line	:	10727 W 159TH ST
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467-4531
Country	:	US
Telephone Number	:	857-207-8517
Fax Number	:

Provider Business Practice Location Address
First Line	:	676 N MICHIGAN AVE STE 3500
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2839
Country	:	US
Telephone Number	:	312-274-3333
Fax Number	:

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

Provider Enumeration Date	:	07/27/2010
Last Update Date	:	11/04/2020

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