Provider Demographics
NPI:1073786463
Name:NORTH SHORE CONSULTANTS IN OB GYN SC
Entity Type:Organization
Organization Name:NORTH SHORE CONSULTANTS IN OB GYN SC
Other - Org Name:ROBERT B ROSENBERG MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-548-9999
Mailing Address - Street 1:1170 E BELVIDERE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2061
Mailing Address - Country:US
Mailing Address - Phone:847-548-9999
Mailing Address - Fax:847-548-8890
Practice Address - Street 1:1170 E BELVIDERE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2061
Practice Address - Country:US
Practice Address - Phone:847-548-9999
Practice Address - Fax:847-548-8890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093911207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1477535151OtherNPI