Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | IL | |
N | 207P00000X | Emergency Physician | 39366 | WI |
NPI | 1003971144 |
---|---|
Provider Name | Dr. Robert W Schwaner |
First Address | Mchenry, IL 60050-3151 |
Second Address | Mchenry, IL 60050-3151 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036047368 2 | (05) | IL |
32399700 | (05) | WI |
E24650 | (02) |