MEDICARE: ZAINEB AL-ABDULLA BCBA

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	103K00000X	Behavior Analyst	1-19-38280	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-19-38280	OTHER	IL	BCBA

General Provider Information

NPI Number	:	1720578511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZAINEB AL-ABDULLA BCBA

Provider Business Mailing Address
First Line	:	4585 N ELSTON AVE APT 207
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-4275
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 W IRVING PARK RD APT 401
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3563
Country	:	US
Telephone Number	:	312-375-4719
Fax Number	:

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

Provider Enumeration Date	:	05/16/2018
Last Update Date	:	05/24/2021

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