Provider Demographics
NPI:1578622809
Name:SABBAGHA, ELIAS R (MD)
Entity type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:R
Last Name:SABBAGHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4895
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-4895
Mailing Address - Country:US
Mailing Address - Phone:312-482-8484
Mailing Address - Fax:312-482-9977
Practice Address - Street 1:106 E OAK ST FL 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1230
Practice Address - Country:US
Practice Address - Phone:312-482-8484
Practice Address - Fax:312-482-9977
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-076140207V00000X, 207V00000X
IL336-039433207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology