Provider Demographics
NPI:1609914134
Name:PERCIVAL A BIGOL MD LTD
Entity Type:Organization
Organization Name:PERCIVAL A BIGOL MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PERCIVAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BIGOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-885-3101
Mailing Address - Street 1:2500 W HIGGINS RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7220
Mailing Address - Country:US
Mailing Address - Phone:847-885-3101
Mailing Address - Fax:847-885-3108
Practice Address - Street 1:2500 W HIGGINS RD
Practice Address - Street 2:SUITE 280
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7220
Practice Address - Country:US
Practice Address - Phone:847-885-3101
Practice Address - Fax:847-885-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098893207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21623235OtherBLUE SHIELD
ILDN3272OtherRR MEDICARE GROUP PTAN
IL036098893Medicaid
ILIL1781Medicare PIN
IL21623235OtherBLUE SHIELD
IL036098893Medicaid
IL567680Medicare PIN