Provider Demographics
NPI:1124258975
Name:RICHARD S. ABRAMS, MD, SC
Entity type:Organization
Organization Name:RICHARD S. ABRAMS, MD, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-348-7003
Mailing Address - Street 1:2016 WILMETTE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2346
Mailing Address - Country:US
Mailing Address - Phone:773-348-7003
Mailing Address - Fax:847-256-7880
Practice Address - Street 1:3525 W PETERSON AVE STE T18
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3312
Practice Address - Country:US
Practice Address - Phone:773-348-7003
Practice Address - Fax:847-256-7880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036036185Medicaid