Provider Demographics
NPI:1306082094
Name:LIEBO, MAX (MD)
Entity type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:LIEBO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:CARDIOLOGY-BLDG.110, RM. 6269
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-327-2738
Mailing Address - Fax:708-327-2773
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:CARDIOLOGY-BLDG.110, RM. 6269
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-327-2738
Practice Address - Fax:708-327-2773
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2021-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036133585207RC0000X
OH57.021226207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease