Provider Demographics
NPI:1104126309
Name:ABDULLAH, YASMIN (APN)
Entity type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 IRWIN AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2316
Mailing Address - Country:US
Mailing Address - Phone:630-926-3468
Mailing Address - Fax:
Practice Address - Street 1:4727 WILLOW SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-6140
Practice Address - Country:US
Practice Address - Phone:630-858-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208008395363LF0000X
IL209008395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily