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NPI Code Detail

MEDICARE: WILLIAM EARL ROBY II

MEDICARE: WILLIAM EARL ROBY II
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1609434737
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM EARL ROBY II
Provider Business Mailing Address
First Line : 3843 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-4623
Country : US
Telephone Number : 773-884-2247
Fax Number :
Provider Business Practice Location Address
First Line : 3843 W 63RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60629-4623
Country : US
Telephone Number : 773-884-2247
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2019
Last Update Date : 06/04/2019

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