Provider Demographics
NPI:1598986275
Name:RASHID A. ABUSHANAB, P.C.
Entity Type:Organization
Organization Name:RASHID A. ABUSHANAB, P.C.
Other - Org Name:BRIDGEVIEW CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHID
Authorized Official - Middle Name:A
Authorized Official - Last Name:ABUSHANAB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:708-599-9250
Mailing Address - Street 1:7124 W 83RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-4024
Mailing Address - Country:US
Mailing Address - Phone:708-599-9250
Mailing Address - Fax:708-599-9470
Practice Address - Street 1:7124 W 83RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455-4024
Practice Address - Country:US
Practice Address - Phone:708-599-9250
Practice Address - Fax:708-599-9470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008510111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1622491OtherBCBS
IL038008510Medicaid
IL038008510Medicaid
IL211431Medicare ID - Type Unspecified
IL038008510Medicaid