MEDICARE: ANNE DOROBA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	036-079194	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518971167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE DOROBA MD

Provider Business Mailing Address
First Line	:	PO BOX 781
Second Line	:
City	:	KANKAKEE
State	:	IL
Zip	:	60901-0781
Country	:	US
Telephone Number	:	815-935-7256
Fax Number	:	815-935-7340

Provider Business Practice Location Address
First Line	:	380 W NORTH ST
Second Line	:
City	:	MANHATTAN
State	:	IL
Zip	:	60442-9839
Country	:	US
Telephone Number	:	815-478-4891
Fax Number	:	815-478-5498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	09/10/2008

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Directions to “ ANNE DOROBA MD” Practice Location

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