| Dr. Bob Tiballi | |
|
2144 Foothill Rd Elgin IL 60123-5871 | |
| (847) 741-4376 | |
| (847) 741-5331 |
| Full Name | Dr. Bob Tiballi |
|---|---|
| Speciality | Internal Medicine |
| Location | 2144 Foothill Rd, Elgin, Illinois |
| Authorized Official Name and Position | Robert N Tiballi (MANAGER) |
| Authorized Official Contact | 8477414376 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Bob Tiballi Po Box 6079 Elgin IL 60121-6079 Ph: (847) 741-4376 | Dr. Bob Tiballi 2144 Foothill Rd Elgin IL 60123-5871 Ph: (847) 741-4376 |
| NPI Number | 1356353270 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 02/23/2023 |
| Certification Date | 02/23/2023 |
| Medicare PECOS PAC ID | 9638152952 |
|---|---|
| Medicare Enrollment ID | O20040609000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356353270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 036091388 (Illinois) | Primary |
| Provider Name | Robert Nicholas Tiballi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194757427 PECOS PAC ID: 6406839737 Enrollment ID: I20090311000528 |
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