Healthcare Provider Details

I. General information

NPI: 1508501263
Provider Name (Legal Business Name): NEVEEN ABUALI DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4417 147TH ST
MIDLOTHIAN IL
60445-2643
US

IV. Provider business mailing address

4527 N SPRINGFIELD AVE
CHICAGO IL
60625-9674
US

V. Phone/Fax

Practice location:
  • Phone: 773-715-9854
  • Fax:
Mailing address:
  • Phone: 773-715-9854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016.006098
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: