Provider Demographics
NPI:1043049679
Name:ABED, YUSIF BASSAM
Entity type:Individual
Prefix:
First Name:YUSIF
Middle Name:BASSAM
Last Name:ABED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 SUNRISE LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-4728
Mailing Address - Country:US
Mailing Address - Phone:708-789-3131
Mailing Address - Fax:
Practice Address - Street 1:9534 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2239
Practice Address - Country:US
Practice Address - Phone:708-598-0500
Practice Address - Fax:708-598-8684
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051306414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist