Basic Information
Provider Information
NPI: 1326094699
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SABALIAUSKAS
FirstName: GAILE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 1919 S HIGHLAND AVE
Address2: SUITE B202 ATTN JAN LEWIS
City: LOMBARD
State: IL
PostalCode: 601486153
CountryCode: US
TelephoneNumber: 6302681102
FaxNumber: 6302681125
Practice Location
Address1: 3825 HIGHLAND AVE
Address2: TOWER 2 SUITE 400
City: DOWNERS GROVE
State: IL
PostalCode: 605151552
CountryCode: US
TelephoneNumber: 6307194799
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/26/2006
LastUpdateDate: 12/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X036102021ILY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

ID Information
IDTypeStateIssuerDescription
03610202105IL MEDICAID
06007144301 RAILROAD MEDICAREOTHER


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