Provider Demographics
NPI:1487655130
Name:LABANA, NEAL J (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:J
Last Name:LABANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:19801 GOVERNORS HWY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422
Mailing Address - Country:US
Mailing Address - Phone:708-957-0505
Mailing Address - Fax:708-957-0506
Practice Address - Street 1:19801 GOVERNORS HWY
Practice Address - Street 2:SUITE 160
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-1029
Practice Address - Country:US
Practice Address - Phone:708-957-0505
Practice Address - Fax:708-957-0506
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2021-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036095205207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036095205Medicaid
IN200328110Medicaid
CK2034Medicare PIN
ILK48383Medicare PIN
INM400018037Medicare PIN
IN200328110Medicaid
ILK15625Medicare PIN
ILL92029Medicare PIN
4571400001Medicare NSC
ILIL3379002Medicare PIN
ILH16088Medicare UPIN
ILIL3377002Medicare PIN
ILIL3378002Medicare PIN
IL036095205Medicaid