Roberts, Bruce
Roberts, Bruce is an individual health care provider with primary practice located at 275 Poplar Rd , Highland Park IL 60035-4346. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Roberts, Bruce can be contacted via phone (312) 404-4261.Contact Information
Primary practice address
275 Poplar Rd
Highland Park IL 60035-4346
Phone: (312) 404-4261
Fax: (708) 202-2085
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 36057770 | Illinois |
Profile Details
| NPI number | 1912974684 |
|---|---|
| LBN Legal business name | Roberts, Bruce |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912974684 | NPPES |
| Illinois | MEDICAID | 36057770 |
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