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NPI Code Detail

MEDICARE: MIMAR ABRAHAM

MEDICARE: MIMAR ABRAHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1306771738
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIMAR ABRAHAM
Provider Business Mailing Address
First Line : 5038 CAROL ST UNIT B
Second Line :
City : SKOKIE
State : IL
Zip : 60077-2201
Country : US
Telephone Number : 847-809-2047
Fax Number :
Provider Business Practice Location Address
First Line : 6500 LINCOLN AVE STE 1000
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-3923
Country : US
Telephone Number : 847-951-4981
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2026
Last Update Date : 06/16/2026

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Directions to “ MIMAR ABRAHAM ” Practice Location

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