Provider Demographics
NPI:1689059297
Name:ATASSI, AMER (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMER
Middle Name:
Last Name:ATASSI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:AMER
Other - Middle Name:
Other - Last Name:ATASSI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:20 BLUE GRASS CT
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2613
Mailing Address - Country:US
Mailing Address - Phone:630-800-3041
Mailing Address - Fax:
Practice Address - Street 1:6224 S ELM ST
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-5228
Practice Address - Country:US
Practice Address - Phone:630-290-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-24
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190301111223P0300X
MI29010171481223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics