Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Khaled Bassam Bishawi

Individual provider General Practice Dentistry · NPI 1205676939

Khaled Bassam Bishawi is a General Practice Dentistry in Riverdale, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2024
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Practice location Address checks out

61 W 144th St
Riverdale, IL 60827-2850
Phone: (708) 849-8627
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 019.035107 (IL)

Record details

NPI number1205676939
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 30, 2024
Last updated in NPPESMay 30, 2024
Certification dateMay 30, 2024

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