Individual
DR. ISMAIL BOBAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 WEST PARK ST, SUITE D2248, URBANA, IL 61801-2396
(217) 337-3738
(217) 337-4569
Mailing address
5300 RELIABLE PKWY, CHICAGO, IL 60686-5300
(708) 633-1234
(708) 342-7272
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036-110991
IL
207RP1001X
Pulmonary Disease Physician
Primary
036110991
IL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
036-110991
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036110991
ILLINOIS MEDICAL LICENSE
IL
05
—
036110991
—
IL
01
—
35437
IOWA MEDICAL LICENSE
IA
01
—
4301078417
MICHIGAN MEDICAL LICENSE
MI
01
—
833120
MEDICARE GROUP #
IL
01
—
CA2264
RR GROUP
IL
01
—
P00446526
RR INDIVIDUAL
IL
Enumeration date
07/02/2006
Last updated
07/26/2024
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