Provider Demographics
NPI:1700643582
Name:ALTARIFI, SALI (DMD)
Entity Type:Individual
Prefix:
First Name:SALI
Middle Name:
Last Name:ALTARIFI
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 1:8042 W 157TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-5908
Mailing Address - Country:US
Mailing Address - Phone:708-527-1121
Mailing Address - Fax:
Practice Address - Street 1:8042 W 157TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-5908
Practice Address - Country:US
Practice Address - Phone:708-527-1211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program