Provider Demographics
NPI:1174844096
Name:ABEL, GRETA L (PA-C)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:L
Last Name:ABEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28375 DAVIS PKWY
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3030
Mailing Address - Country:US
Mailing Address - Phone:630-653-4240
Mailing Address - Fax:630-225-4033
Practice Address - Street 1:1800 N MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-3112
Practice Address - Country:US
Practice Address - Phone:630-653-4240
Practice Address - Fax:630-315-6557
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-001708207V00000X
IL085001708363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL245560OtherMEDICARE
IL206147224OtherMEDICARE PTAN