Organization
BABICH SKIN CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL BABICH (PRACTICE MANAGER)
(217) 876-6890
Entity
Organization
Contact information
Practice address
304 W HAY ST, SUITE 313, DECATUR, IL 62526-6328
(217) 876-6890
(217) 876-6895
Mailing address
304 W HAY ST, SUITE 313, DECATUR, IL 62526-6328
(217) 876-6890
(217) 876-6895
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036-09961
IL
207NS0135X
Procedural Dermatology Physician
036-099961
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007694141
AETNA
IL
01
—
099085
HEALTH ALLIANCE
IL
01
—
5832043
BLUE CROSS
IL
01
—
P00132612
MEDICARE R.R.
IL
Enumeration date
10/09/2007
Last updated
10/10/2007
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