Individual
DR. BRIAN MICHAEL BABKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27650 FERRY RD, WARRENVILLE, IL 60555-3845
(630) 225-2663
(630) 225-2399
Mailing address
27650 FERRY RD, WARRENVILLE, IL 60555-3845
(630) 225-2663
(630) 225-2399
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036105650
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS GROUP ID
IL
05
—
036105650
—
IL
01
—
3631498336019001
CDPG HFS PAYEE ID
IL
Enumeration date
09/08/2005
Last updated
12/09/2014
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