Provider Demographics
NPI:1134192636
Name:BABER, LAURA EDITH (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:EDITH
Last Name:BABER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 WEST HIGGINS RD
Mailing Address - Street 2:SUITE 470
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7220
Mailing Address - Country:US
Mailing Address - Phone:224-653-8324
Mailing Address - Fax:224-653-8365
Practice Address - Street 1:2500 W HIGGINS RD
Practice Address - Street 2:SUITE 470
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7220
Practice Address - Country:US
Practice Address - Phone:224-653-8324
Practice Address - Fax:224-653-8365
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.111276207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036111276Medicaid