MEDICARE: AMIRA ABRAHAM MD

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
1	207Q00000X	Family Medicine Physician	036-107939	IL

General Provider Information

NPI Number	:	1497707129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIRA ABRAHAM MD

Provider Business Mailing Address
First Line	:	6740 NORTH MINNEHAHA
Second Line	:
City	:	LINCOLNWOOD
State	:	IL
Zip	:	60712-3109
Country	:	US
Telephone Number	:	847-692-5206
Fax Number	:	847-692-5394

Provider Business Practice Location Address
First Line	:	8118N MILWAUKEE AVE
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-2817
Country	:	US
Telephone Number	:	847-692-5206
Fax Number	:	847-692-5394

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	07/20/2015

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