=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285778472
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABED E. DEHNEE MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2007
-----------------------------------------------------
Last Update Date | 01/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9650 GROSS POINT RD STE 4900
-----------------------------------------------------
City | SKOKIE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60076-5080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-864-3278
-----------------------------------------------------
Fax | 847-676-1727
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9650 GROSS POINT RD STE 4900
-----------------------------------------------------
City | SKOKIE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60076-5080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-864-3278
-----------------------------------------------------
Fax | 847-676-1727
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 036108068
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | 036-108068
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------