Provider Demographics
NPI:1972736890
Name:CHAHIN, ABDULLAH B (MD)
Entity Type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:B
Last Name:CHAHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 VIRGINIA AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4406
Mailing Address - Country:US
Mailing Address - Phone:401-443-4992
Mailing Address - Fax:401-784-4902
Practice Address - Street 1:10604 SOUTHWEST HWY STE 107
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-2717
Practice Address - Country:US
Practice Address - Phone:708-422-0636
Practice Address - Fax:708-371-9330
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP01727207R00000X
MA253512207R00000X
RIMD14115207RC0200X, 207RG0300X
NH19787207RI0200X
IL036155515207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease