Healthcare Provider Details

I. General information

NPI: 1215257621
Provider Name (Legal Business Name): SAADI A EL-ABAZA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S MICHIGAN AVE
CHICAGO IL
60616-2333
US

IV. Provider business mailing address

2525 S MICHIGAN AVE
CHICAGO IL
60616-2333
US

V. Phone/Fax

Practice location:
  • Phone: 312-567-2000
  • Fax: 312-567-6156
Mailing address:
  • Phone: 312-567-2000
  • Fax: 312-567-6156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036125909
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: