Provider Demographics
NPI:1811010036
Name:ILBAWI, NADIM M (MD)
Entity Type:Individual
Prefix:
First Name:NADIM
Middle Name:M
Last Name:ILBAWI
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 1:4901 SEARLE PKWY
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-5313
Mailing Address - Country:US
Mailing Address - Phone:847-570-5000
Mailing Address - Fax:
Practice Address - Street 1:6810 N MCCORMICK BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-2709
Practice Address - Country:US
Practice Address - Phone:847-674-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.127683207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036.127683OtherIL STATE MEDICAL LICENSE