Provider Demographics
NPI:1437384047
Name:BULBIN, YEVGENY (MD)
Entity Type:Individual
Prefix:DR
First Name:YEVGENY
Middle Name:
Last Name:BULBIN
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 1:1600 DEMPSTER ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1171
Mailing Address - Country:US
Mailing Address - Phone:224-888-3033
Mailing Address - Fax:
Practice Address - Street 1:1600 DEMPSTER ST STE 103
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1171
Practice Address - Country:US
Practice Address - Phone:224-888-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.136818207P00000X
OH35099388207Q00000X
IL036136818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0069557Medicaid
OHH124212Medicare PIN