Provider Demographics
NPI:1649575630
Name:OFFICE ANESTHESIOLOGY AND DENTAL CONSULTANTS, PC
Entity Type:Organization
Organization Name:OFFICE ANESTHESIOLOGY AND DENTAL CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAKARIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MESSIEHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDSANESTHESIOLOGIST
Authorized Official - Phone:630-620-9199
Mailing Address - Street 1:427 W WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2129
Mailing Address - Country:US
Mailing Address - Phone:630-620-9199
Mailing Address - Fax:877-620-5899
Practice Address - Street 1:427 W WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2129
Practice Address - Country:US
Practice Address - Phone:630-620-9199
Practice Address - Fax:877-620-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190243381223D0004X
IN12011109A1223D0004X
IL3190149801223D0004X
IL1370004231223D0004X
IL137-000423207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDentist AnesthesiologistGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty