Individual
DR. JEROME ANTOUN JABBOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2310 YORK ST, SUITE 2 C, BLUE ISLAND, IL 60406-2411
(773) 809-3622
(773) 409-8659
Mailing address
600 N MCCLURG CT, 3806 A, CHICAGO, IL 60611-3044
(248) 802-3842
(248) 802-3842
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01060708A
IN
207Q00000X
Family Medicine Physician
Primary
036119492
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200525220
—
IN
Enumeration date
08/31/2005
Last updated
08/23/2011
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