Individual provider Active NPI

Aghawni Simon Abrahamian, M.D

  • Pediatrics Physician
  • Evanston, IL
National Provider Identifier
1649253238
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Practice address
800 Austin St
Suite 504 W
Evanston, IL 60202-3439
Phone
(847) 332-2770
Fax
(847) 332-2778
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X IL Primary

Addresses

Primary practice location

800 Austin St
Suite 504 W
Evanston, IL 60202-3439

Mailing address

3710 Capri CT
Glenview, IL 60025-3810
Phone (847) 332-2770

Other names 1

  • Dr. Aghawni Simon Abrahamian Professional name

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036070303ILMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1649253238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 CAPRI CT",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253810",
            "telephone_number": "847-332-2770",
            "fax_number": "847-332-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 AUSTIN ST",
            "address_2": "SUITE 504 W",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023439",
            "telephone_number": "847-332-2770",
            "fax_number": "847-332-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAMIAN",
        "first_name": "AGHAWNI",
        "middle_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGHAWNI",
            "last_name": "ABRAHAMIAN",
            "middle_name": "SIMON",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.