Provider Demographics
NPI:1326437633
Name:SYED, MAZHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAZHER
Middle Name:
Last Name:SYED
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 1:3014 S HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-5805
Mailing Address - Country:US
Mailing Address - Phone:312-291-9283
Mailing Address - Fax:
Practice Address - Street 1:9327 SKOKIE BLVD UNIT C
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1310
Practice Address - Country:US
Practice Address - Phone:773-814-4205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-10
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190300090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist