Provider Demographics
NPI:1992704100
Name:SBAI, CHADEN (MD)
Entity type:Individual
Prefix:
First Name:CHADEN
Middle Name:
Last Name:SBAI
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 1:6703 159TH ST
Mailing Address - Street 2:STE 105
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1782
Mailing Address - Country:US
Mailing Address - Phone:708-444-8593
Mailing Address - Fax:708-444-2673
Practice Address - Street 1:6703 159TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1781
Practice Address - Country:US
Practice Address - Phone:708-444-8593
Practice Address - Fax:708-444-2673
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108021207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108021Medicaid
IL036108021Medicaid
ILH77546Medicare UPIN
IL110246003Medicare PIN