Provider Demographics
NPI:1982613006
Name:AMIRY, ABAS A (MD)
Entity Type:Individual
Prefix:MR
First Name:ABAS
Middle Name:A
Last Name:AMIRY
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 1:102A FOX GLEN CT
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1805
Mailing Address - Country:US
Mailing Address - Phone:224-848-4353
Mailing Address - Fax:224-848-4356
Practice Address - Street 1:102A FOX GLEN CT
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1805
Practice Address - Country:US
Practice Address - Phone:224-848-4353
Practice Address - Fax:224-848-4356
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-054225207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036054225Medicaid
ILC45502Medicare UPIN
ILP00916134Medicare PIN
ILP00847235Medicare PIN
IL036054225Medicaid
ILIL3566001Medicare PIN