Doctor Name: | DR. AHUAD L ABDALA |
NPI Number: | 1184837155 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036056658 |
Business Practice Address: | 1824 W. 47th St. Chicago, IL - 60609 |
Business Phone Number: | 7733764040 |
Business Fax Number: | 7738901203 |
Mailing Address: | 6911 Concord Lane, NILES |
State: | IL |
Postal Code: | 60714 |
Phone Number: | 7733764040 |
Fax Number: | 7738901203 |
NPI Enumeration Date: | 05/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036056658 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |