Individual
DR. LISA M. BIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 INGALLS DR, PATHOLOGY DEPARTMENT, HARVEY, IL 60426-3558
(708) 915-5763
(708) 915-3786
Mailing address
1 INGALLS DR, PATHOLOGY DEPARTMENT, HARVEY, IL 60426-3558
(708) 915-5763
(708) 915-3786
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036070178
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036070178
—
IL
01
—
1619826
BCBSIL GROUP NUMBER
—
Enumeration date
07/18/2005
Last updated
11/25/2009
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