Individual
MICHAEL P SIBOL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1775 BALLARD RD, PARK RIDGE, IL 60068-1005
(847) 318-2500
Mailing address
701 LEE ST, SUITE 300, DES PLAINES, IL 60016-4539
(847) 318-2500
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036117299
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621490
BCBS PROVIDER ID
IL
05
—
036117299
—
IL
01
—
P00428425
RAILROAD MEDICARE
IL
Enumeration date
06/27/2007
Last updated
12/17/2021
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