Provider Demographics
NPI:1013056605
Name:ABBOUD, LOUIS M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:M
Last Name:ABBOUD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14466 W ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60083-9512
Mailing Address - Country:US
Mailing Address - Phone:847-662-3028
Mailing Address - Fax:847-872-9645
Practice Address - Street 1:1707 7TH ST
Practice Address - Street 2:
Practice Address - City:WINTHROP HARBOR
Practice Address - State:IL
Practice Address - Zip Code:60096-1656
Practice Address - Country:US
Practice Address - Phone:847-872-5427
Practice Address - Fax:947-872-9645
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist