Healthcare Provider Details

I. General information

NPI: 1659451524
Provider Name (Legal Business Name): ROBERT A SHRIFTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 E DELAWARE PL 15TH FL
CHICAGO IL
60611-1495
US

IV. Provider business mailing address

LBX 809274, PO BOX 809274
CHICAGO IL
60680-9274
US

V. Phone/Fax

Practice location:
  • Phone: 312-440-5150
  • Fax: 312-440-5151
Mailing address:
  • Phone: 773-445-9696
  • Fax: 773-445-9590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: