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General NPI Number Information
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NPI Number | 1891366928
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Entity Type | Individual
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Provider Name | ESRA ABU-ESBA DPM
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Gender | Female
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 320 S ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60607-2856
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Country | US
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Telephone | 512-740-2498
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E CHESTNUT ST APT 1107
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City | CHICAGO
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State | IL
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Zip | 60611-2322
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Country | US
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Telephone |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016.006066
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License Number State | IL
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