Provider Demographics
NPI:1851173330
Name:CAROL STREAM MEDICALPLLC
Entity Type:Organization
Organization Name:CAROL STREAM MEDICALPLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BABINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-517-5674
Mailing Address - Street 1:1189 N GARY AVE
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-9423
Mailing Address - Country:US
Mailing Address - Phone:630-517-5674
Mailing Address - Fax:
Practice Address - Street 1:270 W ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188
Practice Address - Country:US
Practice Address - Phone:630-517-5674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty