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General NPI Number Information
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NPI Number | 1225033137
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Entity Type | Individual
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Provider Name | ROBERT P CHELBERG O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 07/07/2017
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Provider Practice Location Address
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Address Line | W3275 WOLF RIVER ROAD
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City | KESHENA
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State | WI
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Zip | 54135
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Country | US
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Telephone | 715-799-5482
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 970
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City | KESHENA
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State | WI
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Zip | 54135-0970
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Country | US
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Telephone | 715-799-5803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2847-035
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046-009613
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License Number State | IL
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