Corboy, Jacqueline B

Corboy, Jacqueline B is an individual health care provider with primary practice located at 225 E Chicago Ave # 62 , Chicago IL 60611-2991. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Corboy, Jacqueline B can be contacted via phone (800) 543-7362.

Contact Information

Primary practice address
225 E Chicago Ave # 62 Chicago IL 60611-2991
Fax: (312) 227-9475
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036121643 Illinois
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X 036121643 Illinois

Profile Details

NPI number 1174587059
LBN Legal business name Corboy, Jacqueline B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated May 22nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174587059 NPPES
Illinois MEDICAID 036121643

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