MEDICARE: DR. MICHAEL STEVEN GREENBAUM MD

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	2084P0800X	Psychiatry Physician	036080963	IL

General Provider Information

NPI Number	:	1598792970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL STEVEN GREENBAUM MD

Provider Business Mailing Address
First Line	:	900 TECHNOLOGY WAY STE 320
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-5364
Country	:	US
Telephone Number	:	847-680-2715
Fax Number	:	847-680-3832

Provider Business Practice Location Address
First Line	:	900 TECHNOLOGY WAY STE 320
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-5364
Country	:	US
Telephone Number	:	847-680-2715
Fax Number	:	847-680-3832

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	02/09/2022

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