Provider Demographics
NPI:1649253238
Name:ABRAHAMIAN, AGHAWNI SIMON (MD)
Entity type:Individual
Prefix:DR
First Name:AGHAWNI
Middle Name:SIMON
Last Name:ABRAHAMIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AGHAWNI
Other - Middle Name:SIMON
Other - Last Name:ABRAHAMIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3710 CAPRI CT
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3810
Mailing Address - Country:US
Mailing Address - Phone:847-332-2770
Mailing Address - Fax:847-332-2778
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:SUITE 504 W
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-332-2770
Practice Address - Fax:847-332-2778
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics