Provider Demographics
NPI:1831688977
Name:MADWAR, ABDALHAMEED
Entity type:Individual
Prefix:DR
First Name:ABDALHAMEED
Middle Name:
Last Name:MADWAR
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 1:4 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5760
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4286
Practice Address - Country:US
Practice Address - Phone:630-323-4903
Practice Address - Fax:630-323-4909
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032798122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist