Provider Demographics
NPI:1770942823
Name:SAADI, HOMAM WALEED (DDS, MSC)
Entity type:Individual
Prefix:DR
First Name:HOMAM
Middle Name:WALEED
Last Name:SAADI
Suffix:
Gender:M
Credentials:DDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-7222
Mailing Address - Country:US
Mailing Address - Phone:331-233-1001
Mailing Address - Fax:331-233-1002
Practice Address - Street 1:4425 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-7222
Practice Address - Country:US
Practice Address - Phone:331-233-1001
Practice Address - Fax:331-233-1002
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-17
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist