Provider Demographics
NPI:1578047882
Name:SALIH, MOHAMMED (DDS)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:
Last Name:SALIH
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 1:4408 W LAWRENCE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2511
Mailing Address - Country:US
Mailing Address - Phone:773-703-2287
Mailing Address - Fax:773-337-1228
Practice Address - Street 1:4408 W LAWRENCE AVE STE 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2511
Practice Address - Country:US
Practice Address - Phone:773-703-2287
Practice Address - Fax:773-337-1228
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190191861223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics