Provider Demographics
NPI:1922884782
Name:HABRELEWICZ, BAILANIE MONTOK
Entity Type:Individual
Prefix:MS
First Name:BAILANIE
Middle Name:MONTOK
Last Name:HABRELEWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7808 W COLLEGE DR STE LL6
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1027
Mailing Address - Country:US
Mailing Address - Phone:708-968-0072
Mailing Address - Fax:
Practice Address - Street 1:7808 W COLLEGE DR STE LL6
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1027
Practice Address - Country:US
Practice Address - Phone:708-968-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3002422253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care