Prentice, Robert C

Prentice, Robert C is an individual health care provider with primary practice located at 13011 S 104Th Ave Ste 100 , Palos Park IL 60464-1508. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Prentice, Robert C can be contacted via phone (708) 274-3278.

Contact Information

Primary practice address
13011 S 104Th Ave Ste 100 Palos Park IL 60464-1508
Phone: (708) 274-3278
Fax: (708) 274-3299
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036067066 Illinois
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 036067066 Illinois

Profile Details

NPI number 1194789354
LBN Legal business name Prentice, Robert C
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated Dec 15th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194789354 NPPES
Illinois MEDICAID 036067066
Illinois Other 236551
Illinois Other 236550
Illinois Other 01621208
Illinois Other 1508810086
Illinois Other 060042297
Illinois Other 060056572
Illinois Other CD8033
Illinois Other CN2703

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