Powell, Robert

Powell, Robert is an individual health care provider with primary practice located at 964 N 5Th Ave Ste C , St Charles IL 60174-1204. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Powell, Robert can be contacted via phone (630) 208-4215.

Contact Information

Primary practice address
964 N 5Th Ave Ste C St Charles IL 60174-1204
Phone: (630) 208-4215
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X 160.004470 Illinois

Profile Details

NPI number 1477849388
LBN Legal business name Powell, Robert
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2011
Last updated Jun 20th, 2011 - about 14 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 1477849388 NPPES
Illinois Other 36-34784281 FEIN

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