Provider Demographics
NPI:1790321693
Name:HAMILTON, ABIGAIL M (APN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:M
Other - Last Name:DIMALANTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:2259 W TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4233
Mailing Address - Country:US
Mailing Address - Phone:312-285-3982
Mailing Address - Fax:844-835-7034
Practice Address - Street 1:2259 W TAYLOR ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4233
Practice Address - Country:US
Practice Address - Phone:312-285-3982
Practice Address - Fax:844-835-7034
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277.002268363LF0000X
IL209020459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily