Provider Demographics
NPI:1134485774
Name:JAMES M. ABEC, PHD, LTD
Entity Type:Organization
Organization Name:JAMES M. ABEC, PHD, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:ABEC
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-960-4312
Mailing Address - Street 1:477 E BUTTERFIELD RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5618
Mailing Address - Country:US
Mailing Address - Phone:630-960-4312
Mailing Address - Fax:
Practice Address - Street 1:477 E BUTTERFIELD RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5618
Practice Address - Country:US
Practice Address - Phone:630-960-4312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71-1979261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL994300Medicare PIN