Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 016-005133 | IL |
NPI | 1063417830 |
---|---|
Provider Name | Robert J Sheffey |
First Address | Chicago, IL 60655-2205 |
Second Address | Chicago, IL 60655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 03/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001621735 | BCBS (01) | IL |
0001636066 | BCBS (01) | IL |
016005133 | (05) | IL |
131370500 | DEPT OF LABOR (01) | IL |
P00260559 | RAILROAD MEDICARE (01) | IL |
P00390803 | RAILROAD MEDICARE (01) | IL |
V04048 | (02) | IL |