Ghassan Abboud I

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

021003234 Issued in IL

Practice address

5333 N Clark St
Chicago, IL 60640-2121

Phone

(773) 728-5333

Fax

(773) 728-7405

NPI assigned

Oct 10, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• 1St Family Dental of Burr Ridge, PC

  • Dentist
  • Burr Ridge, IL
  • NPI 1801347109
  NPD (past)

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1508854910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402121",
            "telephone_number": "773-728-5333",
            "fax_number": "773-728-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402121",
            "telephone_number": "773-728-5333",
            "fax_number": "773-728-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOUD",
        "first_name": "GHASSAN",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "021003234",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-023616",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Abbott, DO
• Sabra Margaret Abbott, MD, PHD
• William G Abbott, DDS
• Abdallah Abboud
• Elham Abboud, MD
• Sam Abboud
• Samir F Abboud, MD
• Abby Eve Psychotherapy, PLLC
• Abc Dental PC
• Abc Home Health Care Incorporated

• Prosthodontics in Chicago, IL
• Providers in Chicago, IL by specialty
• Prosthodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.