# ORAL & MAXILLOFACIAL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730898933
- **Authorized official:** DR. MOHAMMED QAISI DMD, MD, FACS (OWNER)
- **Authorized official phone:** (773) 296-7645

## Contact information

- **Practice address:** 25 E WASHINGTON ST STE 825, CHICAGO, IL 60602-1722
- **Practice address phone:** (773) 296-7645
- **Practice address fax:** (773) 295-1023
- **Mailing address:** 25 E WASHINGTON ST STE 825, CHICAGO, IL 60602-1722
- **Mailing address phone:** (773) 296-7645
- **Mailing address fax:** (773) 295-1023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | — |

## Other

- **Enumeration date:** 11/16/2022
- **Last updated:** 11/16/2022