Provider Demographics
NPI:1982765624
Name:JEFFREY E KARABAN
Entity Type:Organization
Organization Name:JEFFREY E KARABAN
Other - Org Name:JEFFREY E KARABAN MD & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:KARABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-281-0046
Mailing Address - Street 1:2800 N SHERIDAN ROAD
Mailing Address - Street 2:#210
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6156
Mailing Address - Country:US
Mailing Address - Phone:773-281-0046
Mailing Address - Fax:773-281-0228
Practice Address - Street 1:2800 N SHERIDAN ROAD
Practice Address - Street 2:#210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6156
Practice Address - Country:US
Practice Address - Phone:773-281-0046
Practice Address - Fax:773-281-0228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51496207N00000X
IL207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31620764OtherBCBS
IL720303Medicare ID - Type Unspecified
D15340Medicare UPIN