Provider Demographics
NPI:1366519134
Name:AL-SINAWI, LUBNA A (MD)
Entity type:Individual
Prefix:
First Name:LUBNA
Middle Name:A
Last Name:AL-SINAWI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 MUIRFIELD LN
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3880
Mailing Address - Country:US
Mailing Address - Phone:847-374-0305
Mailing Address - Fax:847-374-0372
Practice Address - Street 1:430 MUIRFIELD LN
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3880
Practice Address - Country:US
Practice Address - Phone:847-374-0305
Practice Address - Fax:847-374-0372
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-108862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3633309286030501Medicaid
IL1619414OtherBCBS GROUP
H12812Medicare UPIN
ILK39340Medicare PIN
IL1619414OtherBCBS GROUP
IL739531003 ICCMedicare PIN