Provider Demographics
NPI:1164316147
Name:ABURMISHAN, NOORA
Entity type:Individual
Prefix:
First Name:NOORA
Middle Name:
Last Name:ABURMISHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3042 BRIDGEHAM ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-8941
Mailing Address - Country:US
Mailing Address - Phone:847-917-5935
Mailing Address - Fax:
Practice Address - Street 1:2022 LARKIN AVE
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5845
Practice Address - Country:US
Practice Address - Phone:630-479-8936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILBACB922495106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician