Provider Demographics
NPI:1508205808
Name:ABDEL-BARRY, DIANE MAGED (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:MAGED
Last Name:ABDEL-BARRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2315
Mailing Address - Country:US
Mailing Address - Phone:312-567-2000
Mailing Address - Fax:
Practice Address - Street 1:47 W POLK ST STE G1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2083
Practice Address - Country:US
Practice Address - Phone:312-567-6700
Practice Address - Fax:312-922-5860
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
IL036144749207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program