Provider Demographics
NPI:1679649388
Name:JABER, NABIL (MD)
Entity Type:Individual
Prefix:DR
First Name:NABIL
Middle Name:
Last Name:JABER
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 1:1106 NORTH LARKIN
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435
Mailing Address - Country:US
Mailing Address - Phone:815-725-6226
Mailing Address - Fax:815-725-6336
Practice Address - Street 1:1106 N LARKIN AVE UPPR LEVEL
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-3455
Practice Address - Country:US
Practice Address - Phone:815-725-6226
Practice Address - Fax:815-725-6336
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036076060208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL005424Medicaid
IL005424Medicaid