| Robert Owens Md Corporation | |
|
326 W 64th St Chicago IL 60621-3114 | |
| (312) 497-0772 | |
| (773) 955-3020 |
| Full Name | Robert Owens Md Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 326 W 64th St, Chicago, Illinois |
| Authorized Official Name and Position | Robert Owens (PHYSICIAN OWNER) |
| Authorized Official Contact | 3124970772 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Owens Md Corporation 5139 S Woodlawn Ave Chicago IL 60615-3901 Ph: (312) 497-0772 | Robert Owens Md Corporation 326 W 64th St Chicago IL 60621-3114 Ph: (312) 497-0772 |
| NPI Number | 1992950778 |
|---|---|
| Provider Enumeration Date | 11/20/2008 |
| Last Update Date | 04/01/2009 |
| Medicare PECOS PAC ID | 4981760832 |
|---|---|
| Medicare Enrollment ID | O20090302000637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992950778 | NPI | - | NPPES |
| 036053016 | Medicaid | IL | |
| 02201400 | Other | BLUE CROSS OF ILLINOIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036053016 (Illinois) | Primary |
| Provider Name | Robert C Owens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598707481 PECOS PAC ID: 5991861841 Enrollment ID: I20090302000627 |
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