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Individual

DR. IYAD SAMIR AWADALLAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
219 N HAMMES AVE STE 3, JOLIET, IL 60435-8145
(815) 725-7900
Mailing address
8697 SCHEER DR, TINLEY PARK, IL 60487-8660
(605) 553-0079

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.028905
IL
1223G0001X
General Practice Dentistry
12012053A
IN

Other

Enumeration date
06/10/2011
Last updated
02/13/2022
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