Organization
LEO TAIBERG, MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEO TAIBERG MD (SOLE PROPRIETOR)
(630) 789-2550
Entity
Organization
Contact information
Practice address
2525 S MICHIGAN AVE, CHICAGO, IL 60616-2333
(630) 789-2550
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634713
BCBS PROVIDER ID
IL
01
—
DC3900
RAIL ROAD MEDICARE
IL
Enumeration date
09/21/2006
Last updated
01/28/2008
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