MEDICARE: DR. CAROLINA G JAPZON REBANDEL 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	207V00000X	Obstetrics & Gynecology Physician		IL

General Provider Information

NPI Number	:	1760471189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLINA G JAPZON REBANDEL MD

Provider Business Mailing Address
First Line	:	2202 N LINCOLN AVE
Second Line	:	STE 4
City	:	CHICAGO
State	:	IL
Zip	:	60614-7170
Country	:	US
Telephone Number	:	773-871-3444
Fax Number	:	773-871-7906

Provider Business Practice Location Address
First Line	:	2202 N LINCOLN AVE
Second Line	:	STE 4
City	:	CHICAGO
State	:	IL
Zip	:	60614-7170
Country	:	US
Telephone Number	:	773-871-3444
Fax Number	:	773-871-7906

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	12/21/2025

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