Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 036132945 | IL |
NPI | 1326205808 |
---|---|
Provider Name | Dr. Anthony Paul Lebario |
First Address | Elgin, IL 60120-3861 |
Second Address | Elgin, IL 60120-3861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 11/11/2021 |