Healthcare Provider Details

I. General information

NPI: 1811010036
Provider Name (Legal Business Name): NADIM M ILBAWI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6810 N MCCORMICK BLVD
LINCOLNWOOD IL
60712-2709
US

IV. Provider business mailing address

4901 SEARLE PKWY SUITE 330
SKOKIE IL
60077-5313
US

V. Phone/Fax

Practice location:
  • Phone: 847-674-6900
  • Fax:
Mailing address:
  • Phone: 847-570-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.127683
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: