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General NPI Number Information
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NPI Number | 1194034116
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Entity Type | Organization
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Legal Business Name | DAVID C. ROBLE, MDSC
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Dates
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Enumeration Date | 09/26/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 960 N 5TH AVE SUITE B
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City | ST CHARLES
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State | IL
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Zip | 60174-1205
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Country | US
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Telephone | 630-584-3029
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Fax | 630-584-3029
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Provider Business Mailing Address
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Address Line | 960 N 5TH AVE SUITE B
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City | ST CHARLES
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State | IL
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Zip | 60174-1205
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Country | US
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Telephone | 630-584-3029
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Fax | 630-584-3029
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID C ROBLE
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Credential | MDSC
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Telephone | 630-584-3029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036044819
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License Number State | IL
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