MEDICARE: ROHNA BOBER APRN, FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	2023018586	IL

General Provider Information

NPI Number	:	1609569458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROHNA BOBER APRN, FNP-BC

Provider Business Mailing Address
First Line	:	565 TRUMAN DR
Second Line	:
City	:	OSWEGO
State	:	IL
Zip	:	60543-7421
Country	:	US
Telephone Number	:	630-674-0258
Fax Number	:

Provider Business Practice Location Address
First Line	:	1030 W DEVON AVE
Second Line	:
City	:	ELK GROVE VILLAGE
State	:	IL
Zip	:	60007-7226
Country	:	US
Telephone Number	:	630-674-0258
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2023
Last Update Date	:	05/29/2023

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