Provider Demographics
NPI:1942287214
Name:HUSSAIN, IFFAT (DDS)
Entity Type:Individual
Prefix:MRS
First Name:IFFAT
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:IFFAT
Other - Middle Name:
Other - Last Name:HUSSAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5865 N LINCOLN AVE
Mailing Address - Street 2:STE #102
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659
Mailing Address - Country:US
Mailing Address - Phone:847-224-9133
Mailing Address - Fax:847-224-9133
Practice Address - Street 1:5865 N LINCOLN AVE
Practice Address - Street 2:STE 102
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659
Practice Address - Country:US
Practice Address - Phone:773-271-6030
Practice Address - Fax:773-271-6030
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019022957122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist