Provider Demographics
NPI:1053476994
Name:YUSAF, SYED BILAL (DDS)
Entity Type:Individual
Prefix:
First Name:SYED BILAL
Middle Name:
Last Name:YUSAF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 N LAGRANGE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-2008
Mailing Address - Country:US
Mailing Address - Phone:815-464-1200
Mailing Address - Fax:815-464-1291
Practice Address - Street 1:346 N LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-2008
Practice Address - Country:US
Practice Address - Phone:815-464-1200
Practice Address - Fax:815-464-1291
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043671706122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist