Provider Demographics
NPI:1194987032
Name:SIBAI, FIRAS (MD)
Entity type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:SIBAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:375 N WALL ST STE P320
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3490
Mailing Address - Country:US
Mailing Address - Phone:815-928-5064
Mailing Address - Fax:815-928-5065
Practice Address - Street 1:375 N WALL ST STE P320
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3490
Practice Address - Country:US
Practice Address - Phone:815-928-5064
Practice Address - Fax:815-928-5065
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036131824207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036131824Medicaid