Individual
IYAD S OMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.H, B.S.
Contact information
Practice address
2803 W 95TH ST, EVERGREEN PARK, IL 60805-2702
(708) 425-1134
Mailing address
2803 W 95TH ST, EVERGREEN PARK, IL 60805-2702
(708) 425-1134
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020013964
IL
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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