Healthcare Provider Details

I. General information

NPI: 1457743510
Provider Name (Legal Business Name): SOBHA JIBY MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SOBHA KOTTOOR

II. Dates (important events)

Enumeration Date: 02/26/2015
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 S ARLINGTON HEIGHTS RD STE 209
ARLINGTON HEIGHTS IL
60005-4144
US

IV. Provider business mailing address

2010 S ARLINGTON HEIGHTS RD STE 209
ARLINGTON HEIGHTS IL
60005-4144
US

V. Phone/Fax

Practice location:
  • Phone: 847-259-8777
  • Fax: 847-259-9994
Mailing address:
  • Phone: 847-259-8777
  • Fax: 847-259-9994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209012520
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: