Healthcare Provider Details

I. General information

NPI: 1902205016
Provider Name (Legal Business Name): JEFFREY DOBIE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 ARTAIUS PKWY STE 200
LIBERTYVILLE IL
60048-5231
US

IV. Provider business mailing address

215 SHUMAN BLVD STE. 401
NAPERVILLE IL
60563-8458
US

V. Phone/Fax

Practice location:
  • Phone: 847-573-0073
  • Fax: 847-573-8660
Mailing address:
  • Phone: 630-303-5380
  • Fax: 978-313-6824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: