Provider Demographics
NPI:1972725224
Name:TRAVEL VACCINATIONS, P.C.
Entity type:Organization
Organization Name:TRAVEL VACCINATIONS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:TIBALLI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:847-781-1790
Mailing Address - Street 1:1555 N. BARRINGTON ROAD, #4100
Mailing Address - Street 2:DOCTORS BUILDING THREE
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169
Mailing Address - Country:US
Mailing Address - Phone:847-781-1790
Mailing Address - Fax:847-781-9973
Practice Address - Street 1:1555 N. BARRINGTON ROAD, #4100
Practice Address - Street 2:DOCTORS BUILDING THREE
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:847-781-1790
Practice Address - Fax:847-781-9973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F46856Medicare UPIN
ILK00795Medicare ID - Type UnspecifiedKANE COUNTY
ILL66058Medicare ID - Type UnspecifiedCOOK COUNTY