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NPI Code Detail

MEDICARE: DR. BASSAM HABBAL MD,FACC,FCCP

MEDICARE:  DR. BASSAM  HABBAL  MD,FACC,FCCP
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
1207RC0000XCardiovascular Disease Physician036-072518IL
2207RC0001XClinical Cardiac Electrophysiology Physician036-072518IL
3207RI0011XInterventional Cardiology Physician036072518IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
221622931OTHERILBCBS GROUP #

General Provider Information

NPI Number : 1427041243
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BASSAM HABBAL MD,FACC,FCCP
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10837 S CICERO AVE STE 200
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-6459
Country : US
Telephone Number : 708-636-7575
Fax Number : 708-636-6193
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 03/11/2025

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Directions to “ DR. BASSAM HABBAL MD,FACC,FCCP” Practice Location

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