Healthcare Provider Details

I. General information

NPI: 1083693378
Provider Name (Legal Business Name): PAUL R ABBO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7411 LAKE ST STE 1120
RIVER FOREST IL
60305-1882
US

IV. Provider business mailing address

7411 LAKE ST STE 1120
RIVER FOREST IL
60305-1882
US

V. Phone/Fax

Practice location:
  • Phone: 708-763-2328
  • Fax: 708-345-9984
Mailing address:
  • Phone: 708-763-2328
  • Fax: 708-345-9984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-096381
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: