Provider Demographics
NPI:1104602333
Name:AKROUSH, LORENE SERHAN
Entity type:Individual
Prefix:DR
First Name:LORENE
Middle Name:SERHAN
Last Name:AKROUSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 DUNDEE AVE
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-4205
Mailing Address - Country:US
Mailing Address - Phone:844-599-3700
Mailing Address - Fax:
Practice Address - Street 1:450 DUNDEE AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-4205
Practice Address - Country:US
Practice Address - Phone:844-599-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019034516122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist