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General NPI Number Information
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NPI Number | 1669403457
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Entity Type | Individual
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Provider Name | ROBERT VINCENT KOLBUSZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 04/04/2013
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Provider Practice Location Address
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Address Line | 2500 S HIGHLAND AVE
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City | LOMBARD
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State | IL
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Zip | 60148-5363
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Country | US
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Telephone | 630-964-2000
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Fax | 630-964-6378
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Provider Business Mailing Address
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Address Line | 2500 S HIGHLAND AVE
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City | LOMBARD
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State | IL
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Zip | 60148-5363
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Country | US
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Telephone | 630-964-2000
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Fax | 630-964-6378
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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 | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 036-070368
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License Number State | IL
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