Provider Demographics
NPI:1861670762
Name:ZAREENA ABBAS MD. SC
Entity Type:Organization
Organization Name:ZAREENA ABBAS MD. SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SURENDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-561-5000
Mailing Address - Street 1:1008 W FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2404
Mailing Address - Country:US
Mailing Address - Phone:773-561-5000
Mailing Address - Fax:773-561-2503
Practice Address - Street 1:1008 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2404
Practice Address - Country:US
Practice Address - Phone:773-561-5000
Practice Address - Fax:773-561-2503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036068929261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635322OtherBLUE CROSS BLUE SHIELD
IL31601507OtherBLUE CROSS BLUE SHIELD
IL212748Medicare PIN