Provider Demographics
NPI:1083395354
Name:ZAIDI, SYEDA BATOOL FATIMA (DMD)
Entity Type:Individual
Prefix:
First Name:SYEDA
Middle Name:BATOOL FATIMA
Last Name:ZAIDI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 N EAST RIVER RD UNIT E
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1219
Mailing Address - Country:US
Mailing Address - Phone:847-772-0192
Mailing Address - Fax:
Practice Address - Street 1:10140 INDIANAPOLIS BLVD STE A
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-3643
Practice Address - Country:US
Practice Address - Phone:219-513-4286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-28
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INPENDING122300000X
IL019.034406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist