Provider Demographics
NPI:1104617877
Name:SABA, ABDIGANI M
Entity type:Individual
Prefix:
First Name:ABDIGANI
Middle Name:M
Last Name:SABA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 SPENSER LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2317
Mailing Address - Country:US
Mailing Address - Phone:847-745-9930
Mailing Address - Fax:
Practice Address - Street 1:3610 SPENSER LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2317
Practice Address - Country:US
Practice Address - Phone:847-745-9930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant