MEDICARE: MACHAI JALEEL COBBS

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	374700000X	Technician	C120-5509-7304	IL

General Provider Information

NPI Number	:	1992657167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACHAI JALEEL COBBS

Provider Business Mailing Address
First Line	:	21901 OLIVIA AVE
Second Line	:
City	:	SAUK VILLAGE
State	:	IL
Zip	:	60411-4937
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21901 OLIVIA AVE
Second Line	:
City	:	SAUK VILLAGE
State	:	IL
Zip	:	60411-4937
Country	:	US
Telephone Number	:	708-248-2111
Fax Number	:

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

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ MACHAI JALEEL COBBS ” Practice Location

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