MEDICARE: ILLIA BOBROV

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist		IL

General Provider Information

NPI Number	:	1134001258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILLIA BOBROV

Provider Business Mailing Address
First Line	:	8639 NILES CENTER RD UNIT 2
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-2323
Country	:	US
Telephone Number	:	773-225-7066
Fax Number	:

Provider Business Practice Location Address
First Line	:	8639 NILES CENTER RD UNIT 2
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-2323
Country	:	US
Telephone Number	:	773-225-7066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	07/21/2025

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Directions to “ ILLIA BOBROV ” Practice Location

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