Individual
JAWDAT ABBOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2425 W. 22ND ST. #205, OAK BROOK, IL 60523-1934
(630) 974-1400
(188) 846-6332
Mailing address
2425 W.22ND STREET #205, OAK BROOK, IL 60523-1934
(630) 974-1400
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036087208
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087208
—
IL
01
—
45-4387283
TAX ID
IL
Enumeration date
08/02/2006
Last updated
09/26/2022
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