Provider Demographics
NPI:1316321722
Name:REHMAN, SYED (DMD)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:
Last Name:REHMAN
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 1:1300 S ELMHURST RD
Mailing Address - Street 2:APT 212
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-5284
Mailing Address - Country:US
Mailing Address - Phone:847-915-2827
Mailing Address - Fax:
Practice Address - Street 1:1300 S ELMHURST RD
Practice Address - Street 2:APT 212
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056
Practice Address - Country:US
Practice Address - Phone:847-915-2827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030260122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice