Active NPI
Ahuad L Abdala, M.D.
- General Practice Physician
- Chicago, IL
National Provider Identifier
1184837155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 036056658
- Practice address
- 1824 W. 47TH St.
Chicago, IL 60609 - Phone
- (773) 376-4040
- Fax
- (773) 890-1203
- NPI assigned
- May 7, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 036056658 | IL | Primary |
Addresses
Primary practice location
1824 W. 47TH St.
Chicago, IL 60609
Mailing address
6911 Concord Lane
Niles, IL 60714
Phone (773) 376-4040
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036056658 | IL | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184837155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6911 CONCORD LANE",
"city": "NILES",
"state": "IL",
"postal_code": "60714",
"telephone_number": "773-376-4040",
"fax_number": "773-890-1203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1824 W. 47TH ST.",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60609",
"telephone_number": "773-376-4040",
"fax_number": "773-890-1203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDALA",
"first_name": "AHUAD",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IL",
"license": "036056658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.