Abraham'S Mark Comprehensive Wellness Center, SC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036096686 Issued in IL

Legal business name

ABRAHAM'S MARK COMPREHENSIVE WELLNESS CENTER, SC

Practice address

9500 S Dorchester Ave
Ste 100
Chicago, IL 60628-1700

Phone

(773) 667-0768

Fax

(773) 667-5529

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Nicole D. King, MDNPI 1558334003

Title

Owner

Phone

(773) 667-0768

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole D King, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1558334003
  Medicare reassignment NPD Authorized official
• Dolorita Hakoma Onguru, MSN, AGACNP-BC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1831664127
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774742400000",
    "number": "1104857341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13677",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154027",
            "telephone_number": "773-667-0768",
            "fax_number": "773-667-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 S DORCHESTER AVE",
            "address_2": "STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281700",
            "telephone_number": "773-667-0768",
            "fax_number": "773-667-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABRAHAM'S MARK COMPREHENSIVE WELLNESS CENTER, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-03-29",
        "certification_date": "2026-03-29",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-667-0768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036096686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1634166",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7455146",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7779286",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "0061621",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3474878",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD MEDICARE",
            "identifier": "DD6694",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Abraham, PA-C
• Rohit Abraham, MD, MPH, MAT
• Sindhu A Abraham, PHARM.D.
• Tanya Abraham, PHARMD
• Tracy A Abraham
• Frida P Abrahamian, MD
• Cyril Abrahams, M.D.
• Joshua Aaron Abrahams, LCSW, MS
• Mary Abrahamsen, DPT
• Cyrus Abrahamson

• Primary Care Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.