Marietta P Abraham, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036109708 Issued in IL

Practice address

10350 Haligus Rd
Huntley, IL 60142-9545

Phone

(815) 338-6600

Fax

(847) 802-7162

NPI assigned

Jun 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premise Health of Illinois Medical PCGroup PAC ID 3971764762, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
• Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Premise Health of Illinois Medical PC

  • Primary Care Clinic/Center
  • Mount Vernon, IL
  • NPI 1427366921
  Medicare reassignment Care Compare group NPD
• Premise Health of Illinois Medical PC

  • Multi-Specialty Clinic/Center
  • Utica, IL
  • NPI 1295518868
  NPD
• Premise Health of Illinois Medical PC

  • Multi-Specialty Clinic/Center
  • Northbrook, IL
  • NPI 1629716121
  NPD
• American Home Visiting Physicians

  • General Practice Physician
  • Des Plaines, IL
  • NPI 1144525510
  NPD (past)
• Centegra Primary Care, LLC

  • Family Medicine Physician
  • Woodstock, IL
  • NPI 1700905205
  NPD (past)
• Fahey Medical Center S.C.

  • Clinic/Center
  • Des Plaines, IL
  • NPI 1780735977
  NPD (past)
• Greater Elgin Emergency Specialists LTD

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1134152366
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northern Illinois Medical Center

  • General Acute Care Hospital
  • McHenry, IL
  • NPI 1982611281
  Care Compare affiliation
• Northwestern Lake Forest Hospital

  • General Acute Care Hospital
  • Lake Forest, IL
  • NPI 1124025176
  Care Compare affiliation

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1376583658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13707 W JACKSON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983188",
            "telephone_number": "815-337-1871",
            "fax_number": "815-338-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 HALIGUS RD",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601429545",
            "telephone_number": "815-338-6600",
            "fax_number": "847-802-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "MARIETTA",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036109708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04532206",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Abadines, PHARMD
• Maria Cristina Abay, CRNA
• Mahera Abbas
• Shabreen Abdul Sharief, MD
• Activefit Physical Therapy and Personal Training
• Afo Dental Group, LTD
• Oladapo Akinkunmi Afolabi
• Helen Afolarin, BSC PH, PHARM.D, MBA
• Ihab Ahmed, MD

• Family Medicine Physician in Huntley, IL
• Providers in Huntley, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.