Provider Demographics
NPI:1982907713
Name:ABRAHAM, ALICE S
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:S
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6629 N KOLMAR AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3331
Mailing Address - Country:US
Mailing Address - Phone:773-865-8341
Mailing Address - Fax:847-679-9713
Practice Address - Street 1:6629 N KOLMAR AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-3331
Practice Address - Country:US
Practice Address - Phone:773-865-8341
Practice Address - Fax:847-679-9713
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter