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NPI Code Detail

MEDICARE: ROBERT W TANNEY D.O.

MEDICARE: ROBERT W TANNEY D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QA0505XAdult Medicine Physician036073747IL

General Provider Information

NPI Number : 1558300038
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT W TANNEY D.O.
Provider Business Mailing Address
First Line : 650 W LAKE COOK RD
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-2082
Country : US
Telephone Number : 847-520-9424
Fax Number : 847-520-9479
Provider Business Practice Location Address
First Line : 650 W LAKE COOK RD
Second Line :
City : BUFFALO GROVE
State : IL
Zip : 60089-2082
Country : US
Telephone Number : 847-520-9424
Fax Number : 847-520-9479
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 10/13/2020

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Directions to “ ROBERT W TANNEY D.O.” Practice Location

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