Individual provider · NPI-1

Jeneson J Abraham, P.A.

Physician Assistant, Medical · Chicago, IL

NPI number1013975218

StatusActive

Last updated in NPPESMay 26, 2021

Details

NPI: 1013975218
Entity type: Individual (NPI-1)
Name: Jeneson J Abraham
Credential: P.A.
Sex: Male
Sole proprietor: No
Enumeration date: May 4, 2006
Certification date: May 26, 2021
Last updated: May 26, 2021

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363AM0700X	Physician Assistant, Medical	085002537	IL	Yes

Practice location

3860 W Ogden Ave
Chicago, IL 60623-2460

Phone 872-588-3000

Mailing address

3860 W Ogden Ave
Chicago, IL 60623-2460

Phone 872-588-3000

Other practice locations

901 Mcclintock Dr
Suite 202
Burr Ridge, IL 60527-0844

Phone 888-220-6432 · Fax 630-654-4253

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