Provider Demographics
NPI:1659484335
Name:STEINBERG, ROBERT IRA (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:IRA
Last Name:STEINBERG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 LATHROP AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1452
Mailing Address - Country:US
Mailing Address - Phone:708-366-8999
Mailing Address - Fax:708-366-1478
Practice Address - Street 1:1139 LATHROP AVE
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1452
Practice Address - Country:US
Practice Address - Phone:708-366-8999
Practice Address - Fax:708-366-1478
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-002999213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL619510Medicare ID - Type Unspecified
T78267Medicare UPIN