DR. KOUSHAN HAIDARZADEH AZAD (NPI# 1154533180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154533180 |
| Entity Type | Individual |
| Full Name | DR. KOUSHAN HAIDARZADEH AZAD |
| Credential | DMD |
| Practice Address |
2240 S Cicero Ave Cicero IL 60804-2411 |
| Mailing Address |
312 Justina St Hinsdale IL 60521-2417 |
| Practice Telephone | 7066562222 |
| Practice Fax Number | 7086523990 |
| Mailing Telephone | 6307060647 |
| Mailing Fax Number | 7086523990 |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
019026920 | IL | Dental Providers |
| Street Address |
2240 S CICERO AVE |
| City | CICERO |
| State | IL |
| Zip Code | 60804-2411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043535248 | Kid Care Doctors | Clinic/Center | 2240 S Cicero Ave, Cicero, IL 60804-2411 | 2010-03-30 |
| 1912139338 | Preeti A Shivakumar | Dentist | 2240 S Cicero Ave, Cicero, IL 60804-2411 | 2009-08-18 |
| 1073776571 | Paul Justin Stec | Dentist | 2240 S Cicero Ave, Cicero, IL 60804 | 2008-07-03 |
| 1629271788 | Darren Alexander Bennett | Dentist | 2240 S Cicero Ave, Cicero, IL 60804-2411 | 2007-06-07 |
| 1952517708 | Frank Vonwesternhagen | Dentist | 2240 S Cicero Ave, Cicero, IL 60804-2411 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265096945 | Jacqueline N/a Gonzalez | Physical Therapy Assistant | 3521 S 56th Ct, Cicero, IL 60804 | 2019-04-27 |
| 1265966832 | Jacqueline Calles | Substance Abuse Rehabilitation Facility | 4904 W. 32nd St, Cicero, IL 60804 | 2017-04-20 |
| 1346667771 | America's Best Contacts & Eyeglasses | Technician/Technologist | 4741 W Cermak Rd, Cicero, IL 60804 | 2014-03-24 |
| 1538580469 | Jesus Paul Sanchez | Behavioral Analyst | 3100 S. Central Ave, Cicero, IL 60804 | 2013-12-19 |
| 1568712123 | Monil P Shah Dmd PC | Dentist | 5539 W Cermak Road, Cicero, IL 60804 | 2012-09-11 |
| 1699073148 | Lolita Aguinaga | Social Worker | 5341 W. Cermak Road, Cicero, IL 60804 | 2011-03-08 |
| 1699949263 | Anne T Gearhart | Pediatrics | 2307 S Cicero Ave, Chicago, IL 60804 | 2008-04-15 |
| 1437332467 | J S Vitamins and More Inc | Durable Medical Equipment & Medical Supplies | 4785 W Cermatz, Circero, IL 60804 | 2007-12-13 |
| 1427171339 | Barbara J Majchrowski | Optometrist | 5729 W 35th Street, Suite 1east, Cicero, IL 60804 | 2007-04-06 |
| 1124190269 | Gulliume Moor | Psychologist | 6117 West Cermak Road, Cicero, IL 60804 | 2006-11-14 |
| Find all providers in zip 60804 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568712123 | Monil P Shah Dmd PC | Dentist | 5539 W Cermak Road, Cicero, IL 60804 | 2012-09-11 |
| 1780949461 | Aryn Nicole Pittman | Dentist | 2254 S Cicero Ave, Cicero, IL 60804-2411 | 2012-07-10 |
| 1558633958 | Arif Samee, Dds Chtd | Dentist | 1639 S Cicero Ave, Cicero, IL 60804-1520 | 2012-01-31 |
| 1154615557 | Timothy Jeffrey Rogers | Dentist | 6130 W Cermak Rd, Cicero, IL 60804-2025 | 2011-06-02 |
| 1184915415 | 3 Stone Dental | Dentist | 5663 E Circle Dr, Suite 600, Cicero, NY 13039-8907 | 2011-04-20 |
| 1447494646 | Precision Dental Care 2, LLC | Dentist | 5317 W Cermak Rd, Cicero, IL 60804-2817 | 2009-05-01 |
| 1043487432 | Allcare Dental & Dentures of Ny PC | Dentist | 5663 E Circle Dr # D 6/7, Suite 600, Cicero, NY 13039-8907 | 2008-05-14 |
| 1568595551 | Jefferson Dental Services,p.c. | Dentist | 8397 Brewerton Rd (us Route 11), Cicero, NY 13039 | 2007-03-13 |
| 1669500112 | New Country Dental Group | Dentist | 5972 Route 31, Cicero, NY 13039 | 2007-02-28 |
| 1972641645 | Blanca L. Salazar | Dentist | 5008 W Cermak Rd, Cicero, IL 60804-2933 | 2007-02-02 |
| Find all providers in CICERO | ||||
Please comment or provide details below to improve the information on DR. KOUSHAN HAIDARZADEH AZAD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.