Healthcare Provider Details

I. General information

NPI: 1578706594
Provider Name (Legal Business Name): TURKIA MAHMUD ABBED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2009
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 SPRING CREEK RD
ROCKFORD IL
61114-6481
US

IV. Provider business mailing address

5995 SPRING CREEK RD
ROCKFORD IL
61114-6481
US

V. Phone/Fax

Practice location:
  • Phone: 815-977-4403
  • Fax: 815-977-5796
Mailing address:
  • Phone: 815-977-4403
  • Fax: 815-977-5796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number036.130634
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number036.130634
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: