MEDICARE: DR. ABBAS F AL-SARAF M.D.

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	207Q00000X	Family Medicine Physician	036109726	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245221134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABBAS F AL-SARAF M.D.

Provider Business Mailing Address
First Line	:	2300 N ROCKTON AVE
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61103-3619
Country	:	US
Telephone Number	:	815-971-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	635 N DEARBORN ST STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-4618
Country	:	US
Telephone Number	:	312-694-2127
Fax Number	:	312-694-2129

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	12/09/2024

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