NPI 1053753061

Yasir Riadh Issa, DDS

Practitioner Dentist Waukegan, IL

Practice location

Address: 1320 Golf Rd, Waukegan, IL 60087-4831
Phone: (847) 336-2800
Fax: (847) 662-0163
Mailing address: 3137 Putter CT, Greenwood, IN 46143-9572

Registered specialties (3)

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 12011992A (IN)

Other Dentist providers in Illinois →

General Practice Dentistry

Dental Providers Taxonomy 1223G0001X Licence 019.029505 (IL)

Dentist

Dental Providers Taxonomy 122300000X Licence 019.029505 (IL)

Registry record

NPI: 1053753061
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Jul 2013
Record last updated: 1 May 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.