MEDICARE: DR. ELHAM ABBOUD

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	246Q00000X	Pathology Specialist/Technologist
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036.095533	IL
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	C206320	CA

General Provider Information

NPI Number	:	1164409447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELHAM ABBOUD

Provider Business Mailing Address
First Line	:	2520 ELISHA AVE
Second Line	:
City	:	ZION
State	:	IL
Zip	:	60099-2676
Country	:	US
Telephone Number	:	847-872-6259
Fax Number	:	847-872-5716

Provider Business Practice Location Address
First Line	:	2361 PAYSPHERE CIRCLE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674
Country	:	US
Telephone Number	:	847-746-4358
Fax Number	:

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	12/30/2025

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