Provider Demographics
NPI:1275675712
Name:JABIR, YOSIF
Entity Type:Individual
Prefix:
First Name:YOSIF
Middle Name:
Last Name:JABIR
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 1:15156 FREEDOM WAY
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-1740
Mailing Address - Country:US
Mailing Address - Phone:630-631-3908
Mailing Address - Fax:
Practice Address - Street 1:13530 S ROUTE 59
Practice Address - Street 2:SUITE J
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5658
Practice Address - Country:US
Practice Address - Phone:815-436-1530
Practice Address - Fax:815-436-4496
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190257761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice