Individual
DR. LEO TAIBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 362-2900
Mailing address
4724 WELLINGTON DR, LONG GROVE, IL 60047-5223
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036.105481
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634713
BCBS PROVIDER ID
IL
05
—
036105481
—
IL
01
—
P00165716
RAIL ROAD MEDICARE
IL
Enumeration date
09/15/2005
Last updated
07/12/2025
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