Provider Demographics
NPI:1477692507
Name:BALBARIN, LILIA FB
Entity Type:Individual
Prefix:DR
First Name:LILIA
Middle Name:FB
Last Name:BALBARIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 WEST CHASE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1935
Mailing Address - Country:US
Mailing Address - Phone:847-674-1993
Mailing Address - Fax:
Practice Address - Street 1:3435 WEST VAN BUREN
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-3359
Practice Address - Country:US
Practice Address - Phone:773-265-4336
Practice Address - Fax:773-265-3607
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D16537Medicare UPIN
IL399390Medicare ID - Type Unspecified