Provider Demographics
NPI:1174962450
Name:SULEIMAN-ATA, SAMIA M (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:SAMIA
Middle Name:M
Last Name:SULEIMAN-ATA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13600 ROUTE 59
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544
Mailing Address - Country:US
Mailing Address - Phone:779-939-0010
Mailing Address - Fax:630-778-2070
Practice Address - Street 1:13600 ROUTE 59
Practice Address - Street 2:SUITE 2
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544
Practice Address - Country:US
Practice Address - Phone:779-939-0010
Practice Address - Fax:630-778-2070
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021.0027851223P0300X
IL019029448122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILAAFDEN3BBSOtherBLUE CROSS BLUE SHIELD IL
IL564197OtherUNITED CONCORDIA
AL62113329OtherBLUE CROSS BLUE SHIELD AL