Provider Demographics
NPI:1780363622
Name:ASKAR, MOHAMMAD (DDS)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:ASKAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 E 93RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-3607
Mailing Address - Country:US
Mailing Address - Phone:773-530-7550
Mailing Address - Fax:773-530-0287
Practice Address - Street 1:1600 E 93RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-3607
Practice Address - Country:US
Practice Address - Phone:773-530-7550
Practice Address - Fax:773-530-0287
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190345141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty