Provider Demographics
NPI:1134101025
Name:SOBLE, MICHAEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:SOBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1800 HOLLISTER DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5263
Mailing Address - Country:US
Mailing Address - Phone:847-367-6781
Mailing Address - Fax:847-367-7384
Practice Address - Street 1:27750 W HIGHWAY 22
Practice Address - Street 2:SUITE G80
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2379
Practice Address - Country:US
Practice Address - Phone:847-842-0850
Practice Address - Fax:847-842-0357
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL98994Medicare PIN
ILL70606Medicare PIN
ILG92351Medicare UPIN