Provider Demographics
NPI:1649215757
Name:BABICH, DEBRA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:
Last Name:BABICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-3269
Mailing Address - Country:US
Mailing Address - Phone:217-330-8939
Mailing Address - Fax:217-330-9063
Practice Address - Street 1:2880 N MONROE ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-3269
Practice Address - Country:US
Practice Address - Phone:217-330-8939
Practice Address - Fax:217-330-9063
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-099961207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL007694141OtherAETNA
IL5832043OtherBLUE CROSS
IL435223OtherHEALTHLINK
IL0360999613Medicaid
IL435223OtherHEALTHLINK
ILF48768Medicare UPIN