Provider Demographics
NPI:1760789069
Name:SABA KAMAL, D.D.S., P. C.
Entity Type:Organization
Organization Name:SABA KAMAL, D.D.S., P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SABA
Authorized Official - Middle Name:SHEIKH
Authorized Official - Last Name:KAMAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-921-6067
Mailing Address - Street 1:PO BOX 3614
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60138-3614
Mailing Address - Country:US
Mailing Address - Phone:708-921-6067
Mailing Address - Fax:
Practice Address - Street 1:2001 S CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2486
Practice Address - Country:US
Practice Address - Phone:773-484-1201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190276151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty