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NPI Code Detail

MEDICARE: WILLIAM BOBLICK MD

MEDICARE: WILLIAM BOBLICK 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
1207R00000XInternal Medicine Physician36059082IL

Other Identifiers

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

General Provider Information

NPI Number : 1932173267
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM BOBLICK MD
Provider Business Mailing Address
First Line : 2160 S 1ST AVE
Second Line : (7005 W. NOTH AVE., OAK PARK, IL 60302)
City : MAYWOOD
State : IL
Zip : 60153-3328
Country : US
Telephone Number : 708-383-8888
Fax Number : 708-383-8932
Provider Business Practice Location Address
First Line : 2160 S 1ST AVE
Second Line : (7005 W. NOTH AVE., OAK PARK, IL 60302)
City : MAYWOOD
State : IL
Zip : 60153-3328
Country : US
Telephone Number : 708-383-8888
Fax Number : 708-383-8932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 08/18/2009

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