MEDICARE: DR. ABBAS A CHAMSUDDIN M.D.

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	2085R0204X	Vascular & Interventional Radiology Physician	25MA0684700	NJ
2	2085R0202X	Diagnostic Radiology Physician	61599	CT
3	2085R0202X	Diagnostic Radiology Physician	25MA0684700	NJ
4	2085R0202X	Diagnostic Radiology Physician	051028	GA
5	2085R0204X	Vascular & Interventional Radiology Physician	61599	CT
6	207U00000X	Nuclear Medicine Physician	036.147556	IL
7	2085R0202X	Diagnostic Radiology Physician	036.147556	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578539557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABBAS A CHAMSUDDIN M.D.

Provider Business Mailing Address
First Line	:	1 FEDERAL ST STE 200
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1088
Country	:	US
Telephone Number	:	848-288-6935
Fax Number	:	732-790-0107

Provider Business Practice Location Address
First Line	:	8201 EAST RIVERSIDE BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1461
Country	:	US
Telephone Number	:	815-971-7000
Fax Number	:

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	09/12/2025

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