Healthcare Provider Details

I. General information

NPI: 1891743175
Provider Name (Legal Business Name): LINA MAY ABUJAMRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N CHILDRENS PLZ BOX 62
CHICAGO IL
60614-3363
US

IV. Provider business mailing address

1322 S PRAIRIE AVE APT 1104
CHICAGO IL
60605-3064
US

V. Phone/Fax

Practice location:
  • Phone: 773-880-8245
  • Fax:
Mailing address:
  • Phone: 312-945-0628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: