Healthcare Provider Details

I. General information

NPI: 1467737320
Provider Name (Legal Business Name): TONI M ABRAMOVSKE P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 10/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N HIGHLAND AVE
AURORA IL
60506-1449
US

IV. Provider business mailing address

14940 S 88TH AVE
ORLAND PARK IL
60462-3448
US

V. Phone/Fax

Practice location:
  • Phone: 630-859-2222
  • Fax:
Mailing address:
  • Phone: 708-362-1816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085004136
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: