Provider Demographics
NPI:1285124792
Name:ELNAGAR, MOHAMMED H (DDS,MSC)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:H
Last Name:ELNAGAR
Suffix:
Gender:M
Credentials:DDS,MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:801 S PAULINA ST RM 131
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-7210
Mailing Address - Country:US
Mailing Address - Phone:312-996-0873
Mailing Address - Fax:312-996-0873
Practice Address - Street 1:801 S PAULINA ST RM 131
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-7210
Practice Address - Country:US
Practice Address - Phone:312-996-7505
Practice Address - Fax:312-996-0873
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL136.0002131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics