Provider Demographics
NPI:1225039738
Name:JOOB, AXEL W (MD)
Entity type:Individual
Prefix:
First Name:AXEL
Middle Name:W
Last Name:JOOB
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:1875 DEMPSTER ST STE 265
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1126
Practice Address - Country:US
Practice Address - Phone:847-723-1550
Practice Address - Fax:847-723-1551
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036076771208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC51047Medicare UPIN