Organization
J. BOB ACHEBE MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BOB ACHEBE MD (OWNER)
(773) 333-5782
Entity
Organization
Contact information
Practice address
10810 S HALSTED ST, CHICAGO, IL 60628-3126
(773) 785-9000
Mailing address
10810 S HALSTED ST, CHICAGO, IL 60628-3126
(773) 785-9000
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
036054592
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036054592
—
IL
01
—
21606987
BCBSIL
IL
Enumeration date
03/28/2007
Last updated
11/03/2009
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