Organization Name: | RIAZ BABER MD SC |
NPI Number: | 1295956522 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAVIER BANUELOS (BILLING MANAGER) |
Mailing Address: | 1460 Bond St Suite 130 Naperville |
State: | IL US |
Postal Code: | 605636502 |
Phone Number: | 6308590120 |
Fax Number: | 6303557679 |
NPI Enumeration Date: | 05/02/2007 |
NPI Last Update Date: | 12/31/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |