Provider Demographics
NPI:1003992413
Name:ABRAMS, RICHARD STEVEN
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:STEVEN
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 W PETERSON AVE STE T18
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3312
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036036185174400000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036036185Medicaid
ILD12279Medicare UPIN
IL036036185Medicaid
IL1002992413Medicare PIN