Provider Demographics
NPI:1013026004
Name:JABRI, MOHAMED I (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:I
Last Name:JABRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 DICKENS AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-4303
Mailing Address - Country:US
Mailing Address - Phone:630-548-1407
Mailing Address - Fax:
Practice Address - Street 1:1149 DICKENS AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4303
Practice Address - Country:US
Practice Address - Phone:630-548-1407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-090331207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-090331OtherMEDICAL LICENSE