Provider Demographics
NPI:1184012759
Name:BABAYEV, ELNUR
Entity Type:Individual
Prefix:
First Name:ELNUR
Middle Name:
Last Name:BABAYEV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 N WESTMORELAND RD
Mailing Address - Street 2:NORTHWESTERN MEDICAL GROUP
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-9989
Mailing Address - Country:US
Mailing Address - Phone:847-234-5600
Mailing Address - Fax:847-535-7203
Practice Address - Street 1:1000 N WESTMORELAND RD
Practice Address - Street 2:NORTHWESTERN MEDICAL GROUP
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-9989
Practice Address - Country:US
Practice Address - Phone:847-234-5600
Practice Address - Fax:847-535-7203
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2019-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036144939207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program