Provider Demographics
NPI:1275364366
Name:AL MUGHRABI, ANAS (DMD)
Entity type:Individual
Prefix:DR
First Name:ANAS
Middle Name:
Last Name:AL MUGHRABI
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 1:9618 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2862
Mailing Address - Country:US
Mailing Address - Phone:888-411-8648
Mailing Address - Fax:708-907-3165
Practice Address - Street 1:9618 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2862
Practice Address - Country:US
Practice Address - Phone:708-424-5901
Practice Address - Fax:708-424-5903
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0354501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice