Provider Demographics
NPI:1801100391
Name:ASHTEWI, FAISEL ABDULHAMID
Entity type:Individual
Prefix:DR
First Name:FAISEL
Middle Name:ABDULHAMID
Last Name:ASHTEWI
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 1:10727 W 159TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-4531
Mailing Address - Country:US
Mailing Address - Phone:857-207-8517
Mailing Address - Fax:
Practice Address - Street 1:676 N MICHIGAN AVE STE 3500
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2839
Practice Address - Country:US
Practice Address - Phone:312-274-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0305211223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics