Abbasi M.D.S.C.
Organization Active NPI Cardiovascular Disease Physician · Orland Park, IL
NPI 1083880348 · NPPES record last updated Apr 30, 2013
Key facts
- NPI
- 1083880348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 036068401 (IL)
- Legal business name
- ABBASI M.D.S.C.
- Practice address
- 10639 Great Egret Dr
Orland Park, IL 60467-8490 - Phone
- (708) 460-9192
- Fax
- (708) 310-4327
- NPI assigned
- May 6, 2008
- Organization subpart
- No
Authorized official
- Name
- Tahir A Abbasi, M.D.
- Title
- President
- Phone
- (708) 206-1090
Practitioners 3
-
Tahir A Abbasi, M.D.
-
Nazila Shafagati, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080701000575 | IL | Part B Supplier - Clinic/Group Practice | 8325110612 |
Receives reassigned benefits from 1 practitioner Practice locations: Tinley Park, IL; South Holland, IL; Flossmoor, IL; Orland Park, IL; Hazel Crest, IL; Harvey, IL; Chicago Heights, IL; Chicago, IL… |
National Provider Directory
Locations
17680 Kedzie Ave
Ste 206
Hazel Crest, IL 60429
Phone (708) 206-1090
17680 Kedzie Ave
Ste 2
Hazel Crest, IL 60429
16000 Wabash Ave
South Holland, IL 60473
Phone (219) 769-9009
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician |
207RC0000X | 036068401 | IL | Yes |
Addresses
Primary practice location
10639 Great Egret Dr
Orland Park, IL 60467-8490
Mailing address
17680 Kedzie Ave
206
Hazel Crest, IL 60429-2043
Phone (708) 206-1090
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036068401 | Medicaid | IL |
Other providers in Orland Park, IL
- A&E Medical Services, LLC
- A2Z Healthcare Services, LLC.
- A2Z Medical Supplies
- A2Z Medical Supplies, Co.
- Abanoub, LLC
- Doreen Abbinanti Glomb
- Abc Developmental Play, LTD
- Lamese Abdelhamid
- Awni Hamdi Abdelqader
- Salah-Aldean Abdullah
All providers in Orland Park, IL · Cardiovascular Disease Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.