Provider Demographics
NPI:1205354024
Name:HAMDI, AHMED Q A
Entity type:Individual
Prefix:DR
First Name:AHMED
Middle Name:Q A
Last Name:HAMDI
Suffix:
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 1:1412 WESLEY CT
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-4109
Mailing Address - Country:US
Mailing Address - Phone:847-404-5742
Mailing Address - Fax:
Practice Address - Street 1:9312 SKOKIE BLVD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1309
Practice Address - Country:US
Practice Address - Phone:847-673-3621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031375122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist