Healthcare Provider Details

I. General information

NPI: 1124197322
Provider Name (Legal Business Name): ROBERT JAMES SKOPEK DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/27/2023
Certification Date: 07/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S. WYNSTONE PARK DRIVE SUITE 102
NORTH BARRINGTON IL
60010
US

IV. Provider business mailing address

444 N RAND RD
NORTH BARRINGTON IL
60010-1401
US

V. Phone/Fax

Practice location:
  • Phone: 847-277-1212
  • Fax: 847-713-2472
Mailing address:
  • Phone: 847-277-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number019-023828
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: