Healthcare Provider Details

I. General information

NPI: 1942178520
Provider Name (Legal Business Name): ABDI CORONA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10537 S ROBERTS RD
PALOS HILLS IL
60465-1933
US

IV. Provider business mailing address

5352 S WASHTENAW AVE APT 1
CHICAGO IL
60632-2215
US

V. Phone/Fax

Practice location:
  • Phone: 708-974-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.113002
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: