MEDICARE: ABIGAIL ELIZABETH CASMERE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	10005170A	IN

General Provider Information

NPI Number	:	1053150557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL ELIZABETH CASMERE

Provider Business Mailing Address
First Line	:	6619 WALNUT GROVE CT
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60516-3035
Country	:	US
Telephone Number	:	630-796-1483
Fax Number	:

Provider Business Practice Location Address
First Line	:	931 E 86TH ST STE 104
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-1852
Country	:	US
Telephone Number	:	317-257-1484
Fax Number	:	317-257-1488

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2024
Last Update Date	:	02/02/2026

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