Basic Information
| Provider Information | |||||||||
| NPI: | 1245278910 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LLOBET | ||||||||
| FirstName: | XIMENA | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LLOBET | ||||||||
| OtherFirstName: | XIMENA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1901 BUTTERFIELD RD | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | DOWNERS GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605157915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6307252768 | ||||||||
| FaxNumber: | 6307252783 | ||||||||
| Practice Location | |||||||||
| Address1: | 2150 E LAKE COOK RD | ||||||||
| Address2: | SUITE 40 - C | ||||||||
| City: | BUFFALO GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600891862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474656025 | ||||||||
| FaxNumber: | 8474656050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 01/26/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 036-110889 | IL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 208D00000X | 036110889 | IL | Y | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | P00157423 | 01 | IL | MEDICARE RAILROAD | OTHER | P00226729 | 01 | IL | MEDICARE RAILROAD | OTHER | 036110889 | 05 | IL | MEDICAID |