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1689305765
HUSAM HIWIADI
WAUKEGAN, IL
NPI
1689305765
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019.033617)
Enumeration Date
2022-06-21
Last Update Date
2022-06-29
Business Address
HUSAM HIWIADI DMD
3953 FOUNTAIN SQUARE PL
WAUKEGAN, IL 60085-6705
Phone number: 817-793-8559
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Mailing Address
HUSAM HIWIADI DMD
450 WARRENVILLE RD APT 455
LISLE, IL 60532-1664
Phone number: 817-793-8559
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