Provider Demographics
NPI:1053107516
Name:ABDALLAH, TUMODIR ATTA (MD)
Entity type:Individual
Prefix:DR
First Name:TUMODIR
Middle Name:ATTA
Last Name:ABDALLAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14508 S STIRRUP CT
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-9297
Mailing Address - Country:US
Mailing Address - Phone:708-401-3804
Mailing Address - Fax:
Practice Address - Street 1:6071 W. OUTER DRIVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-966-3250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-19
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program