Provider Demographics
NPI:1245325018
Name:ABBOUD, WOROOD (MD)
Entity type:Individual
Prefix:
First Name:WOROOD
Middle Name:
Last Name:ABBOUD
Suffix:
Gender:F
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:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:2614 W. JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435
Practice Address - Country:US
Practice Address - Phone:815-725-1355
Practice Address - Fax:815-725-9857
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-103016207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK30830OtherMEDICARE INDIV ID# FOR GROUP 336140
ILK30832OtherMEDICARE INDIV ID# FOR GROUP 208256
IL036103016Medicaid
ILK30831OtherMEDICARE ID# FOR GROUP 205474
ILP00371773OtherMEDICARE RR
ILP00371773OtherMEDICARE RR
ILK30832OtherMEDICARE INDIV ID# FOR GROUP 208256
ILK30831OtherMEDICARE ID# FOR GROUP 205474
IL208256Medicare PIN