Individual
DR. ROBERT N TIBALLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2144 FOOTHILL RD, ELGIN, IL 60123-5871
(847) 741-4376
(847) 741-5331
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036091388
IL
207R00000X
Internal Medicine Physician
5100
TN
207RI0200X
Infectious Disease Physician
010925
AZ
207RI0200X
Infectious Disease Physician
036091388
IL
207RI0200X
Infectious Disease Physician
Primary
1055-321
WI
207RI0200X
Infectious Disease Physician
5100
TN
208M00000X
Hospitalist Physician
5100
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091388
—
IL
01
—
440001730
RR MEDICARE
IL
Enumeration date
07/07/2006
Last updated
12/19/2024
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