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General NPI Number Information
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NPI Number | 1770654725
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Entity Type | Individual
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Provider Name | ABDUL SABOOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 100 E JEFFERY ST
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City | KANKAKEE
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State | IL
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Zip | 60901-5018
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Country | US
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Telephone | 815-939-8011
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Fax | 815-939-8383
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Provider Business Mailing Address
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Address Line | 19434 SOUTHFIELD LN
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City | TINLEY PARK
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State | IL
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Zip | 60487-5160
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Country | US
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Telephone | 815-806-0735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01061899A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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