Healthcare Provider Details

I. General information

NPI: 1851576045
Provider Name (Legal Business Name): ROBERT W BOXER MDSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SKOKIE BLVD SUITE 140
NORTHBROOK IL
60062-2856
US

IV. Provider business mailing address

500 SKOKIE BLVD SUITE 140
NORTHBROOK IL
60062-2856
US

V. Phone/Fax

Practice location:
  • Phone: 847-272-4296
  • Fax:
Mailing address:
  • Phone: 847-272-4296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: ROBERT W BOXER
Title or Position: PRESIDENT
Credential: MD
Phone: 847-272-4296