Provider Demographics
NPI:1578734505
Name:STRAWBERRY DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:STRAWBERRY DENTAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS, PHD
Authorized Official - Phone:708-989-7899
Mailing Address - Street 1:621 MEACHAM RD
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3020
Mailing Address - Country:US
Mailing Address - Phone:847-891-8570
Mailing Address - Fax:847-891-8572
Practice Address - Street 1:621 MEACHAM RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3020
Practice Address - Country:US
Practice Address - Phone:847-891-8570
Practice Address - Fax:847-891-8572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty