MEDICARE: STEVEN M DOBRYMAN 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	207L00000X	Anesthesiology Physician		IL

General Provider Information

NPI Number	:	1982634986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN M DOBRYMAN MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1718
Country	:	US
Telephone Number	:	847-570-1206
Fax Number	:	847-570-1248

Provider Business Practice Location Address
First Line	:	718 GLENVIEW AVE
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-2432
Country	:	US
Telephone Number	:	847-480-3852
Fax Number	:	847-480-3712

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	07/08/2007

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