| None | |
|
1100 Joliet St Ste 201 Dyer IN 46311-1995 | |
| (630) 974-1400 | |
| (888) 466-3320 |
| Full Name | None |
|---|---|
| Speciality | Internal Medicine |
| Location | 1100 Joliet St Ste 201, Dyer, Indiana |
| Authorized Official Name and Position | Jawdat Abboud (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6309741400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| None 1100 Joliet St Ste 201 Dyer IN 46311-1995 Ph: (630) 974-1400 | None 1100 Joliet St Ste 201 Dyer IN 46311-1995 Ph: (630) 974-1400 |
| NPI Number | 1427771237 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 01/04/2023 |
| Medicare PECOS PAC ID | 0547632713 |
|---|---|
| Medicare Enrollment ID | O20230216001195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427771237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jawdat Abboud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417964370 PECOS PAC ID: 2264330901 Enrollment ID: I20230216001241 |
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