Provider Demographics
NPI:1396571337
Name:AL JANABY, REYAM HISHAM MOBDER (DMD)
Entity type:Individual
Prefix:
First Name:REYAM
Middle Name:HISHAM MOBDER
Last Name:AL JANABY
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 1:2760 S HIGHLAND AVE APT 427
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5433
Mailing Address - Country:US
Mailing Address - Phone:847-630-2340
Mailing Address - Fax:
Practice Address - Street 1:2760 S HIGHLAND AVE APT 427
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5433
Practice Address - Country:US
Practice Address - Phone:847-630-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.035314122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist