Provider Demographics
NPI:1477541811
Name:AL-SABEK, FUWAD (DMD, MS)
Entity Type:Individual
Prefix:
First Name:FUWAD
Middle Name:
Last Name:AL-SABEK
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24228 W. LOCKPORT STREET
Mailing Address - Street 2:SUITE:-102
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544
Mailing Address - Country:US
Mailing Address - Phone:815-577-1883
Mailing Address - Fax:815-577-2010
Practice Address - Street 1:24228 W. LOCKPORT STREET
Practice Address - Street 2:SUITE :- 102
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544
Practice Address - Country:US
Practice Address - Phone:815-577-1883
Practice Address - Fax:815-577-2010
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190264381223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics