Provider Demographics
NPI:1760991285
Name:A.B.R.A.M. INC.
Entity Type:Organization
Organization Name:A.B.R.A.M. INC.
Other - Org Name:A.B.R.A.M. ELECTRICAL CONSTRUCTION & SUPPLY CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DARON
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PH T
Authorized Official - Phone:773-488-2887
Mailing Address - Street 1:P.O. BOX 21904
Mailing Address - Street 2:6751 SO. EMERALD
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621-2509
Mailing Address - Country:US
Mailing Address - Phone:773-488-2887
Mailing Address - Fax:
Practice Address - Street 1:6751 S EMERALD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-2509
Practice Address - Country:US
Practice Address - Phone:773-488-2887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A.B.R.A.M.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILW252-1617-3197172A00000X
IL049122123183700000X
333300000X, 3336S0011X, 343800000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No333300000XSuppliersEmergency Response System Companies
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty