Provider Demographics
NPI:1235528787
Name:AL-SAADI, TAREK
Entity Type:Individual
Prefix:
First Name:TAREK
Middle Name:
Last Name:AL-SAADI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6902 MARTIN DR
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1932
Mailing Address - Country:US
Mailing Address - Phone:216-375-9889
Mailing Address - Fax:
Practice Address - Street 1:14403 S BELL RD
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-7881
Practice Address - Country:US
Practice Address - Phone:708-966-4018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190339611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice