Individual provider Active NPI

Iftikharul H Abbasy, MD

  • Surgery Physician
  • Oak Brook, IL
National Provider Identifier
1104814755
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Practice address
2425 W 22ND St
Suite 211
Oak Brook, IL 60523-1245
Phone
(630) 575-8789
Fax
(630) 575-0720
NPI assigned
Oct 7, 2005
Last updated
Jan 30, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X IL Primary

Addresses

Primary practice location

2425 W 22ND St
Suite 211
Oak Brook, IL 60523-1245

Mailing address

PO Box 3333
Oak Brook, IL 60522-3333
Phone (630) 575-8789

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036 042779ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harris S Goldenberg, M.D., S.C. PastSince Apr 28, 2015 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1104814755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3333",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605223333",
            "telephone_number": "630-575-8789",
            "fax_number": "630-575-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W 22ND ST",
            "address_2": "SUITE 211",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231245",
            "telephone_number": "630-575-8789",
            "fax_number": "630-575-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBASY",
        "first_name": "IFTIKHARUL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.