Individual
ISSA ABEDMAHMOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3020 S PARK AVE, HERRIN, IL 62948-3721
(618) 988-1877
(618) 988-8578
Mailing address
PO BOX 1096, HERRIN, IL 62948-1096
(618) 988-1877
(618) 988-8578
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036097793
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097793
—
IL
01
—
050625
HEATLH ALLIANCE
—
01
—
10023061
BCBS IL
—
01
—
416686
HEATHLINK
—
01
—
59806
GHP ACCESS
—
Enumeration date
11/30/2005
Last updated
11/18/2008
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