Provider Demographics
NPI:1174668826
Name:SHAKEEL, MOHAMMED ABDUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:ABDUL
Last Name:SHAKEEL
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 1:190 N SWIFT RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-1476
Mailing Address - Country:US
Mailing Address - Phone:630-627-7626
Mailing Address - Fax:630-627-7626
Practice Address - Street 1:190 N SWIFT RD
Practice Address - Street 2:SUITE G
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-1476
Practice Address - Country:US
Practice Address - Phone:630-627-7626
Practice Address - Fax:630-627-7626
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-026011122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist