Physician Compare National (NPI:1194757427)

HEALTHCARE PROVIDER: ROBERT N TIBALLI D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1194757427
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406839737
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090311000528
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TIBALLI
	Individual professional last name
Provider First Name	ROBERT
	Individual professional first name
Provider Middle Name	N
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	INFECTIOUS DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1710 N RANDALL RD
	Group Practice or individual's line 1 address
City	ELGIN
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	601239400
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140239
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ROCKFORD MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140242
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CENTRAL DUPAGE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140116
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	CENTEGRA HOSPITAL-MCHENRY
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	140030
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ADVOCATE SHERMAN HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	140217
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	PRESENCE SAINT JOSEPH HOSPITAL - ELGIN
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1194757427)

HEALTHCARE PROVIDER: ROBERT N TIBALLI D.O.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information