Healthcare Provider Details

I. General information

NPI: 1124657473
Provider Name (Legal Business Name): ANDREW ERIC ABADIER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 S MICHIGAN AVE APT 4101
CHICAGO IL
60605-2415
US

IV. Provider business mailing address

808 S MICHIGAN AVE APT 4101
CHICAGO IL
60605-2415
US

V. Phone/Fax

Practice location:
  • Phone: 401-465-4731
  • Fax:
Mailing address:
  • Phone: 401-465-4731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number125078238
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: