Basic Information
| Provider Information | |||||||||
| NPI: | 1730508052 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABBASS | ||||||||
| FirstName: | MOHAMMAD ALI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 259 E ERIE ST STE 1600 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606113111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126955620 | ||||||||
| FaxNumber: | 3126952729 | ||||||||
| Practice Location | |||||||||
| Address1: | 259 E ERIE ST STE 1600 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606113111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126955620 | ||||||||
| FaxNumber: | 3126952729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2014 | ||||||||
| LastUpdateDate: | 10/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 35.133719 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 208C00000X | 036153116 | IL | Y | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |
No ID Information.