Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016.003027 | IL |
Y | 222Z00000X | Podiatrist | 016.003027 | IL |
N | 213EP1101X | Primary Podiatric Medicine | 316.000674 | IL |
NPI | 1194940106 |
---|---|
Provider Name | Dr. Robert M Bester |
First Address | Woodridge, IL 60517 |
Second Address | Woodridge, IL 60517 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 06/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
480022587 | RR MEDICARE (01) | IL |
T37234 | (02) | IL |