Basic Information
| Provider Information | |||||||||
| NPI: | 1245325018 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABBOUD | ||||||||
| FirstName: | WOROOD | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1860 PAYSPHERE CIR | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606740018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304699200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2614 W. JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | JOLIET | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157251355 | ||||||||
| FaxNumber: | 8157259857 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 06/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 036-103016 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | K30830 | 01 | IL | MEDICARE INDIV ID# FOR GROUP 336140 | OTHER | 036103016 | 05 | IL | MEDICAID | K30832 | 01 | IL | MEDICARE INDIV ID# FOR GROUP 208256 | OTHER | K30831 | 01 | IL | MEDICARE ID# FOR GROUP 205474 | OTHER | P00371773 | 01 | IL | MEDICARE RR | OTHER |