Individual
NOOR AMINAH OBAISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1208 LAURA LN, WOODRIDGE, IL 60517-5062
(217) 314-0033
Mailing address
1208 LAURA LN, WOODRIDGE, IL 60517-5062
(217) 314-0033
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019028304
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002568
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417392457
—
IL
Enumeration date
05/03/2013
Last updated
04/29/2025
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