Healthcare Provider Details

I. General information

NPI: 1407906696
Provider Name (Legal Business Name): CARL M SILBERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 W WINCHESTER RD STE 112
LIBERTYVILLE IL
60048-5365
US

IV. Provider business mailing address

1870 W WINCHESTER RD STE 112
LIBERTYVILLE IL
60048-5365
US

V. Phone/Fax

Practice location:
  • Phone: 847-224-0165
  • Fax: 847-367-7345
Mailing address:
  • Phone: 847-224-0165
  • Fax: 815-462-4955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number036056039
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: