Healthcare Provider Details

I. General information

NPI: 1437327020
Provider Name (Legal Business Name): MUHAMMED SALAH LABABIDY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 COPPERFIELD AVE SUITE 4060
JOLIET IL
60432-2004
US

IV. Provider business mailing address

903 129TH INFANTRY DR SUITE 400
JOLIET IL
60435-3171
US

V. Phone/Fax

Practice location:
  • Phone: 815-740-1301
  • Fax: 815-723-6778
Mailing address:
  • Phone: 815-725-2653
  • Fax: 815-744-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number036119353
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: