Obadah Asbahi

Individual provider Active NPI Family Medicine Physician · Berwyn, IL

NPI 1073207486 · NPPES record last updated May 15, 2025

Key facts

NPI
1073207486
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
125085703 (IL)
Practice address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone
(708) 783-2000
NPI assigned
Jun 7, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250724000828 IL Order and Referring Only - Family Practice
Practitioner - Family Practice
8628584786

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 125085703 IL Yes

Addresses

Primary practice location

3249 Oak Park Ave
Berwyn, IL 60402-3429

Mailing address

3249 Oak Park Ave
Berwyn, IL 60402-3429

Other practice location 1

515 N Michigan Ave
Saginaw, MI 48602-4316
Phone (989) 583-0000

Other providers in Berwyn, IL

All providers in Berwyn, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.