Healthcare Provider Details

I. General information

NPI: 1467712596
Provider Name (Legal Business Name): SHABIRHUSAIN SHAKIR ABADIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 W POLK ST STE 625
CHICAGO IL
60612-3723
US

IV. Provider business mailing address

1900 W POLK ST STE 625
CHICAGO IL
60612-3723
US

V. Phone/Fax

Practice location:
  • Phone: 312-903-0204
  • Fax:
Mailing address:
  • Phone: 312-903-0204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036125620
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036.125620
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: