Healthcare Provider Details

I. General information

NPI: 1124837034
Provider Name (Legal Business Name): SBK MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2321 W DEVON AVE
CHICAGO IL
60659-2003
US

IV. Provider business mailing address

2321 W DEVON AVE
CHICAGO IL
60659-2003
US

V. Phone/Fax

Practice location:
  • Phone: 773-672-3376
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MIRZA SAADULLAH BAIG
Title or Position: ADMINISTRATOR
Credential:
Phone: 773-672-3376