Provider Demographics
NPI:1104664804
Name:MOHAMED IBRAHIM, RASHEEDHA BEGUM (DMD)
Entity type:Individual
Prefix:DR
First Name:RASHEEDHA BEGUM
Middle Name:
Last Name:MOHAMED IBRAHIM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 BUCKINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-1667
Mailing Address - Country:US
Mailing Address - Phone:224-770-1138
Mailing Address - Fax:
Practice Address - Street 1:298 W NORTH AVE # 4
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-1159
Practice Address - Country:US
Practice Address - Phone:630-530-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0353651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice