Applebaum, Robert Ethan

Applebaum, Robert Ethan is an individual health care provider with primary practice located at 2310 York St Suite 3A, Blue Island IL 60406-2411. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Applebaum, Robert Ethan can be contacted via phone (708) 371-2057.

Contact Information

Primary practice address
2310 York St Suite 3A Blue Island IL 60406-2411
Phone: (708) 371-2057
Fax: (708) 371-4569
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 036074981 Illinois
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 01035864A Indiana

Profile Details

NPI number 1477553188
LBN Legal business name Applebaum, Robert Ethan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2005
Last updated Nov 19th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477553188 NPPES
Indiana MEDICAID 200269990C
Indiana MEDICAID 200269990D
Indiana MEDICAID 036074981
Indiana Other 01618941
Indiana MEDICAID 200269990A
Indiana MEDICAID 200269990E

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