MEDICARE: MS. REBECCA ABRAHAM PA-C

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	208M00000X	Hospitalist Physician	085006649	IL
2	363A00000X	Physician Assistant	085006649	IL
3	363AM0700X	Medical Physician Assistant		IL

General Provider Information

NPI Number	:	1902397078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA ABRAHAM PA-C

Provider Business Mailing Address
First Line	:	5145 N CALIFORNIA AVE OFC M331
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3687
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5145 N CALIFORNIA AVE OFC M331
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625
Country	:	US
Telephone Number	:	773-878-8200
Fax Number	:

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

Provider Enumeration Date	:	05/24/2018
Last Update Date	:	03/19/2026

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