Individual
JAMES BOB ACHEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10810 S HALSTED ST, CHICAGO, IL 60628-3126
(773) 785-9000
(773) 785-9191
Mailing address
10810 S HALSTED ST, CHICAGO, IL 60628-3126
(773) 785-9000
(773) 785-9191
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
036-054592
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036 054592
—
IL
01
—
21606987
BLUE CROSS/SHIELD
IL
01
—
793013234
RAIL ROAD MEDICARE
IL
Enumeration date
09/21/2006
Last updated
12/04/2009
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