| Dhccltd | |
|
319 N Weber Rd 397 Bolingbrook IL 60490-1569 | |
| (773) 656-3170 | |
| Not Available |
| Full Name | Dhccltd |
|---|---|
| Speciality | Dentist |
| Location | 319 N Weber Rd, Bolingbrook, Illinois |
| Authorized Official Name and Position | Mohamed Waheed (DENTIST) |
| Authorized Official Contact | 7736563170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dhccltd 319 N Weber Rd 397 Bolingbrook IL 60490-1569 | Dhccltd 319 N Weber Rd 397 Bolingbrook IL 60490-1569 Ph: (773) 656-3170 |
| NPI Number | 1174916233 |
|---|---|
| Provider Enumeration Date | 03/13/2015 |
| Last Update Date | 03/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174916233 | NPI | - | NPPES |
| 019028978 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019028978 (Illinois) | Primary |
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