Provider Demographics
NPI:1063425965
Name:ABBASY, SHAMEEM (MD)
Entity type:Individual
Prefix:
First Name:SHAMEEM
Middle Name:
Last Name:ABBASY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 N CALIFORNIA AVE STE 635
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-7066
Mailing Address - Country:US
Mailing Address - Phone:773-907-3038
Mailing Address - Fax:773-293-8899
Practice Address - Street 1:5140 N CALIFORNIA AVE STE 635
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-7066
Practice Address - Country:US
Practice Address - Phone:773-907-3038
Practice Address - Fax:773-293-8899
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361153862088F0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL962341Medicare PIN