Healthcare Provider Details

I. General information

NPI: 1093782146
Provider Name (Legal Business Name): IRAM SHAIKH-ABBASI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 08/29/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WALKER AVE STE B
CLARENDON HILLS IL
60514-1351
US

IV. Provider business mailing address

4 WALKER AVE STE B
CLARENDON HILLS IL
60514-1351
US

V. Phone/Fax

Practice location:
  • Phone: 630-468-2034
  • Fax: 866-242-0565
Mailing address:
  • Phone: 630-468-2034
  • Fax: 866-242-0565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036-116426
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: