Individual provider Active NPI

Nabella Doreen Abedin, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Belleville, IL
National Provider Identifier
1093976136
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
125055323 Issued in IL
Practice address
180 S 3Rd St
Ste 400
Belleville, IL 62220-1952
Phone
(618) 233-7880
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 125055323 IL Primary

Addresses

Primary practice location

180 S 3Rd St
Ste 400
Belleville, IL 62220-1952

Mailing address

180 S 3Rd St
Ste 400
Belleville, IL 62220-1952
Phone (618) 233-7880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125055323ILMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213920000000",
    "number": "1093976136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 S 3RD ST",
            "address_2": "STE 400",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201952",
            "telephone_number": "618-233-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S 3RD ST",
            "address_2": "STE 400",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201952",
            "telephone_number": "618-233-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEDIN",
        "first_name": "NABELLA",
        "middle_name": "DOREEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125055323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.