Roberg, Bradford C

Roberg, Bradford C is an sole proprietor health care provider with primary practice located at 5714 S State Route 31 , Crystal Lake IL 60014-4520. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Roberg, Bradford C can be contacted via phone (815) 356-7000.

Contact Information

Primary practice address
5714 S State Route 31 Crystal Lake IL 60014-4520
Phone: (815) 356-7000
Fax: (815) 356-7513
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X Illinois

Profile Details

NPI number 1316946072
LBN Legal business name Roberg, Bradford C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2005
Last updated Jul 8th, 2007 - about 19 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 1316946072 NPPES
Illinois Other 00732007 BLUE SHIELD OF ILLINOIS

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