Provider Demographics
NPI:1356565089
Name:HIBA PEDIATRICS
Entity type:Organization
Organization Name:HIBA PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SABA
Authorized Official - Middle Name:HALIM
Authorized Official - Last Name:KHALID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-791-8002
Mailing Address - Street 1:2915 S ELLIS AVE
Mailing Address - Street 2:1ST FLR. KUNSTADTER CHILDRENS BUILDING ,MICHAEL REESE H
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3302
Mailing Address - Country:US
Mailing Address - Phone:312-791-8002
Mailing Address - Fax:312-791-2093
Practice Address - Street 1:2915 S ELLIS AVE
Practice Address - Street 2:1ST FLR. KUNSTADTER CHILDRENS BUILDING ,MICHAEL REESE H
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3302
Practice Address - Country:US
Practice Address - Phone:312-791-8002
Practice Address - Fax:312-791-2093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherTIN