Provider Demographics
NPI:1720190200
Name:ALBI, JOYCE A (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:ALBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:711 DARTMOUTH LN
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-3818
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 COPPERFIELD AVE
Practice Address - Street 2:SUITE 202, AUNT MARTHA'S
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-2054
Practice Address - Country:US
Practice Address - Phone:815-724-0840
Practice Address - Fax:815-724-0842
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036068436207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036068436Medicaid
D15416Medicare UPIN