Provider Demographics
NPI:1942472287
Name:ROBERT J LUBER MD
Entity Type:Organization
Organization Name:ROBERT J LUBER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-882-8679
Mailing Address - Street 1:990 GRAND CANYON PKWY
Mailing Address - Street 2:STE LL14
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1739
Mailing Address - Country:US
Mailing Address - Phone:847-882-8679
Mailing Address - Fax:847-882-8657
Practice Address - Street 1:990 GRAND CANYON PKWY
Practice Address - Street 2:STE LL14
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1739
Practice Address - Country:US
Practice Address - Phone:847-882-8679
Practice Address - Fax:847-882-8657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0181280001Medicare NSC