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General NPI Number Information
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NPI Number | 1083880348
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Entity Type | Organization
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Legal Business Name | ABBASI M.D.S.C.
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 10639 GREAT EGRET DR
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City | ORLAND PARK
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State | IL
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Zip | 60467-8490
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Country | US
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Telephone | 708-460-9192
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Fax | 708-310-4327
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Provider Business Mailing Address
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Address Line | 17680 KEDZIE AVE 206
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City | HAZEL CREST
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State | IL
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Zip | 60429-2043
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Country | US
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Telephone | 708-206-1090
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Fax | 708-310-4327
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAHIR A ABBASI
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Credential | M.D.
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Telephone | 708-206-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036068401
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License Number State | IL
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