Healthcare Provider Details

I. General information

NPI: 1295312551
Provider Name (Legal Business Name): ANTHONY ABADIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MADISON ST STE 300
OAK PARK IL
60302-4210
US

IV. Provider business mailing address

930 CHESTNUT RIDGE RD
MORGANTOWN WV
26505-2807
US

V. Phone/Fax

Practice location:
  • Phone: 708-486-2700
  • Fax: 708-486-2702
Mailing address:
  • Phone: 304-293-8724
  • Fax: 304-293-5323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036175097
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: