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General NPI Number Information
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NPI Number | 1356406185
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Entity Type | Individual
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Provider Name | ROBERT NACLERIO MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 180 HARVESTER DR STE 110
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City | BURR RIDGE
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State | IL
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Zip | 60527-6686
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Country | US
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Telephone | 773-834-4064
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Fax |
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Provider Business Mailing Address
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Address Line | 9910 FRANKLIN SQUARE DR STE 2110
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City | BALTIMORE
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State | MD
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Zip | 21236-4902
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Country | US
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Telephone | 773-702-0080
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Fax | 773-702-9813
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | D25122
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 036088518
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License Number State | IL
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