Provider Demographics
NPI:1225317209
Name:SHAREEF, SHEHBAZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHEHBAZ
Middle Name:
Last Name:SHAREEF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 DUNDEE AVE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-2232
Mailing Address - Country:US
Mailing Address - Phone:847-902-0963
Mailing Address - Fax:847-488-9147
Practice Address - Street 1:1185 DUNDEE AVE
Practice Address - Street 2:SUITE A1
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-2232
Practice Address - Country:US
Practice Address - Phone:847-902-0963
Practice Address - Fax:847-488-9147
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0288161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice