Provider Demographics
NPI:1518144906
Name:OAK BROOK SMILES, P.C.
Entity Type:Organization
Organization Name:OAK BROOK SMILES, P.C.
Other - Org Name:UMAR HAQUE, D.M.D., LTD.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:UMAR
Authorized Official - Middle Name:U
Authorized Official - Last Name:HAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-627-7420
Mailing Address - Street 1:1S132 SUMMIT AVE
Mailing Address - Street 2:#200
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3955
Mailing Address - Country:US
Mailing Address - Phone:630-627-7420
Mailing Address - Fax:630-627-2520
Practice Address - Street 1:1S132 SUMMIT AVE
Practice Address - Street 2:#200
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3955
Practice Address - Country:US
Practice Address - Phone:630-627-7420
Practice Address - Fax:630-627-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19026077261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental