Healthcare Provider Details

I. General information

NPI: 1528530771
Provider Name (Legal Business Name): SAJU ABRAHAM, M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2018
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OGDEN AVE
AURORA IL
60504-5893
US

IV. Provider business mailing address

7156 W 127TH ST UNIT 300
PALOS HEIGHTS IL
60463-1560
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-6200
  • Fax:
Mailing address:
  • Phone: 708-586-2080
  • Fax: 708-575-2876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAJU ABRAHAM
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 708-586-2080