Provider Demographics
NPI:1811425085
Name:ABDELRAHIM, SAMI M (DMD)
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:M
Last Name:ABDELRAHIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9137 PEPPERWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:ORLAND HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60487-5649
Mailing Address - Country:US
Mailing Address - Phone:708-595-3769
Mailing Address - Fax:
Practice Address - Street 1:5501 W 79TH ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-1784
Practice Address - Country:US
Practice Address - Phone:708-349-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist