Individual
GAMAL S NAGUIB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
302 E SAINT CHARLES RD, VILLA PARK, IL 60181-2420
(630) 936-4410
(630) 563-9174
Mailing address
8135 N MILWAUKEE AVE, NILES, IL 60714-2828
(847) 967-8098
(847) 967-8594
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
019014756
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019014756
—
IL
01
—
33060
BLUE SHIELD OF ILLINOIS
IL
Enumeration date
07/14/2005
Last updated
07/21/2022
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