Shoberg, David Scott
Shoberg, David Scott is an sole proprietor health care provider with primary practice located at 7144 Kleckner Rd , Rockford IL 61107-6821. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Pulmonology, which is considered as his primary health care specialty. Shoberg, David Scott can be contacted via phone (815) 636-7111.Contact Information
Primary practice address
7144 Kleckner Rd
Rockford IL 61107-6821
Phone: (815) 636-7111
Fax: (815) 639-3526
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Pulmonology | 2080P0214X | 036083667 | Illinois |
Profile Details
| NPI number | 1982783361 |
|---|---|
| LBN Legal business name | Shoberg, David Scott |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 4th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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 | 1982783361 | NPPES |
| Illinois | Other | 10123666 | BCBS |
| Illinois | MEDICAID | 036083667 | BCBS |
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