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Individual

JEFFREY S. BAKAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1786 MOON LAKE BLVD, SUITE #100, HOFFMAN ESTATES, IL 60169-5029
(847) 882-9300
(847) 882-9348
Mailing address
1786 MOON LAKE BLVD, SUITE #100, HOFFMAN ESTATES, IL 60169-5029
(847) 882-9300
(847) 882-9348

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036086309
IL
207ND0900X
Dermatopathology Physician
036086309
IL
207NP0225X
Pediatric Dermatology Physician
036086309
IL
207NS0135X
Procedural Dermatology Physician
036086309
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360863092
IL
01
1621016
BCBS
Enumeration date
07/20/2005
Last updated
01/29/2020
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