MEDICARE: DR. DENNIS C ABELLA DO

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	207R00000X	Internal Medicine Physician	036-062694	IL

General Provider Information

NPI Number	:	1962498451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS C ABELLA DO

Provider Business Mailing Address
First Line	:	800 BIESTERFIELD RD
Second Line	:	STE 705A
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3361
Country	:	US
Telephone Number	:	847-981-6061
Fax Number	:	847-981-6062

Provider Business Practice Location Address
First Line	:	800 BIESTERFIELD RD
Second Line	:	STE 705A
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-3361
Country	:	US
Telephone Number	:	847-981-6061
Fax Number	:	847-981-6062

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	04/02/2019

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