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General NPI Number Information
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NPI Number | 1932108255
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Entity Type | Individual
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Provider Name | DEBRA A. BAKAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 1786 MOON LAKE BLVD SUITE #100
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-1016
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Country | US
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Telephone | 847-882-9300
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Fax | 847-882-9348
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Provider Business Mailing Address
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Address Line | 1786 MOON LAKE BLVD SUITE #100
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-1016
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Country | US
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Telephone | 847-882-9300
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Fax | 847-882-9348
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 036086031
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | 036086031
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 036086031
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 036086031
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License Number State | IL
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