Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 019.029082 | IL |
Y | 1223X0400X | Orthodontists | 021.002680 | IL |
NPI | 1033473764 |
---|---|
Provider Name | Dr. Robert F Schwartz |
First Address | Algonquin, IL 60102-5917 |
Second Address | Algonquin, IL 60102-5917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2012 |
Last Update Date | 19/08/2020 |