Individual
MARIBE FE BANGAYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4640 N MARINE DR, CHICAGO, IL 60640-5719
(773) 564-5577
(773) 564-5578
Mailing address
5140 N. CALIFORNIA AVE., SUITE 740-GMP, CHICAGO, IL 60625
(773) 989-3957
(773) 989-3971
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036100866
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036100866
IL
207RP1001X
Pulmonary Disease Physician
Primary
036100866
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100866
—
IL
Enumeration date
07/07/2005
Last updated
04/30/2021
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