Provider Demographics
NPI:1023149697
Name:ABRAHAM, KURIAN P (MD)
Entity type:Individual
Prefix:
First Name:KURIAN
Middle Name:P
Last Name:ABRAHAM
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 1:2000 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7222
Mailing Address - Country:US
Mailing Address - Phone:630-692-5025
Mailing Address - Fax:630-898-6473
Practice Address - Street 1:2000 OGDEN AVENUE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504
Practice Address - Country:US
Practice Address - Phone:630-692-5025
Practice Address - Fax:630-898-6473
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36074466207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE43589Medicare UPIN
ILL84912Medicare ID - Type Unspecified