Provider Demographics
NPI:1184131500
Name:GELANI, HATEM M SR
Entity type:Individual
Prefix:DR
First Name:HATEM
Middle Name:M
Last Name:GELANI
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 111TH ST APT 107
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-0006
Mailing Address - Country:US
Mailing Address - Phone:617-380-8663
Mailing Address - Fax:
Practice Address - Street 1:552 S WASHINGTON ST STE 220
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6670
Practice Address - Country:US
Practice Address - Phone:231-737-0037
Practice Address - Fax:231-760-5497
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190317351223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty