MEDICARE: HOMER ABIAD 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	207R00000X	Internal Medicine Physician	036-090881	IL
2	207RI0200X	Infectious Disease Physician	336-063910	IL

General Provider Information

NPI Number	:	1871596817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOMER ABIAD M.D.

Provider Business Mailing Address
First Line	:	15900 CICERO AVE
Second Line	:
City	:	OAK FOREST
State	:	IL
Zip	:	60452-4006
Country	:	US
Telephone Number	:	708-633-4133
Fax Number	:	708-633-3029

Provider Business Practice Location Address
First Line	:	15900 CICERO AVE
Second Line	:
City	:	OAK FOREST
State	:	IL
Zip	:	60452-4006
Country	:	US
Telephone Number	:	708-633-4133
Fax Number	:	708-633-3029

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	04/21/2021

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