Healthcare Provider Details

I. General information

NPI: 1972736890
Provider Name (Legal Business Name): ABDULLAH B CHAHIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10604 SOUTHWEST HWY STE 107
CHICAGO RIDGE IL
60415-2717
US

IV. Provider business mailing address

17 VIRGINIA AVE SUITE 107
PROVIDENCE RI
02905-4406
US

V. Phone/Fax

Practice location:
  • Phone: 708-422-0636
  • Fax: 708-371-9330
Mailing address:
  • Phone: 401-443-4992
  • Fax: 401-784-4902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036155515
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036155515
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number036155515
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: