Provider Demographics
NPI:1013918473
Name:ABRAMOWITZ, BRUCE M (MD,FACC)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:M
Last Name:ABRAMOWITZ
Suffix:
Gender:M
Credentials:MD,FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2401
Mailing Address - Country:US
Mailing Address - Phone:708-636-7575
Mailing Address - Fax:708-636-7193
Practice Address - Street 1:10837 S CICERO AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-6458
Practice Address - Country:US
Practice Address - Phone:708-636-7575
Practice Address - Fax:708-636-6193
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-062475207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL060053888OtherPALMETTO GBA INIVIDUAL #
IL036032475Medicaid
IL21622931OtherBCBS GROUP #
ILCI8250OtherPALMETTO GBA GROUP #
IL036032475Medicaid
ILL68065Medicare ID - Type UnspecifiedINDIVIDUAL PROVIDER ID #
IL060053888OtherPALMETTO GBA INIVIDUAL #