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NPI Code Detail

MEDICARE: DR. ROBERT C OWENS M.D.

MEDICARE:  DR. ROBERT C OWENS  M.D.
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
1207R00000XInternal Medicine Physician036053016IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598707481
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT C OWENS M.D.
Provider Business Mailing Address
First Line : 5139 S WOODLAWN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-3901
Country : US
Telephone Number : 773-955-6050
Fax Number : 773-955-3020
Provider Business Practice Location Address
First Line : 8124 S COTTAGE GROVE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60619-5104
Country : US
Telephone Number : 312-807-9272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 12/20/2010

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Directions to “ DR. ROBERT C OWENS M.D.” Practice Location

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