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Homer Abiad

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NPI Number Detailed Information

Provider Information:

Name: Homer Abiad
Gender: M
Provider License Number If Given: 036-090881

NPI Information:

NPI: 1871596817
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/9/2020

Provider Business Mailing Address:

Address: 15900 CICERO AVE
Oak Forest, IL 60452
Phone Number: 7086334133
Fax Number: 7086333029

Provider Business Practice Location Address:

Address: 15900 CICERO AVE
Oak Forest, IL 60452
Phone Number: 7086334133
Fax Number: 7086333029

Provider Taxonomy:

Primary: 207R00000X
Secondary (if any): 207RI0200X
State: IL

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