Provider Demographics
NPI:1174572929
Name:ABDEL-JALIL, SUHAIR (MD)
Entity type:Individual
Prefix:DR
First Name:SUHAIR
Middle Name:
Last Name:ABDEL-JALIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:800 AUSTIN ST
Mailing Address - Street 2:SUITE 163
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3439
Mailing Address - Country:US
Mailing Address - Phone:847-316-3880
Mailing Address - Fax:847-316-3883
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:SUITE 163
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-316-3880
Practice Address - Fax:847-316-3883
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036088858174400000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036088858Medicaid
ILL72087Medicare PIN
IL551170Medicare PIN
IL21623195OtherBCBS