Provider Demographics
NPI:1447753413
Name:UEHLEIN, ROBERT (CPO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:UEHLEIN
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5589 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-5063
Mailing Address - Country:US
Mailing Address - Phone:708-878-4570
Mailing Address - Fax:630-424-0392
Practice Address - Street 1:1S376 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3985
Practice Address - Country:US
Practice Address - Phone:630-424-0392
Practice Address - Fax:630-424-0467
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224P00000X
IL211.000169222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211.000169OtherLICENSED ORTHOTIST
IL213.000130OtherLICENSED PROSTHETIST