Healthcare Provider Details

I. General information

NPI: 1265451397
Provider Name (Legal Business Name): BABAK MOKHLESI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 02/26/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RUSH UNIVERSITY MEDICAL CENTER 1750 W. HARRISON ST. JELKE 213
CHICAGO IL
60637-3825
US

IV. Provider business mailing address

1750 W. HARRISON ST. JELKE 213
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-5440
  • Fax:
Mailing address:
  • Phone: 312-942-5440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036094442
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number036094442
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036094442
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: