MEDICARE: DR. SAMER DIBS 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	207RC0001X	Clinical Cardiac Electrophysiology Physician	36102728	IL

Other Identifiers

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

General Provider Information

NPI Number	:	1952359242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMER DIBS MD

Provider Business Mailing Address
First Line	:	PO BOX 257610
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-8633
Country	:	US
Telephone Number	:	773-728-0000
Fax Number	:	773-728-0002

Provider Business Practice Location Address
First Line	:	2222 W DIVISION ST STE 330
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2995
Country	:	US
Telephone Number	:	773-728-0000
Fax Number	:	773-728-0002

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	12/31/2021

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Directions to “ DR. SAMER DIBS MD” Practice Location

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