Provider Demographics
NPI:1598797839
Name:GAROFALO, ROBERT (MD MPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GAROFALO
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CHILDRENS PLAZA
Mailing Address - Street 2:CHILDRENS MEMORIAL HOSPITAL BOX 16
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614
Mailing Address - Country:US
Mailing Address - Phone:773-388-8661
Mailing Address - Fax:773-281-4237
Practice Address - Street 1:2300 CHILDRENS PLAZA
Practice Address - Street 2:CHILDRENS MEMORIAL HOSPITAL BOX 16
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614
Practice Address - Country:US
Practice Address - Phone:773-880-4551
Practice Address - Fax:773-281-4237
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G45681Medicare UPIN
ILK17429Medicare ID - Type Unspecified