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Individual

DR. MOHAMMAD HABIB BAWANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1105 W PARK AVE, SUITE 1, LIBERTYVILLE, IL 60048-2567
(847) 680-5880
(847) 680-5881
Mailing address
1105 W PARK AVE, SUITE 1, LIBERTYVILLE, IL 60048-2567
(847) 680-5880
(847) 680-5881

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036067603
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4901136
BC BS PROVIDER ID
IL
Enumeration date
08/12/2005
Last updated
07/08/2007
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