Provider Demographics
NPI:1760167555
Name:ABU-KWEIK, AMANNIE YACOUB (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMANNIE
Middle Name:YACOUB
Last Name:ABU-KWEIK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 MADISON ST UNIT 305
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4013
Mailing Address - Country:US
Mailing Address - Phone:330-224-8440
Mailing Address - Fax:
Practice Address - Street 1:44 S VAIL AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1879
Practice Address - Country:US
Practice Address - Phone:847-253-4626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190342841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice