Provider Demographics
NPI:1740335041
Name:NEEMS, ROBERT L
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:NEEMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 W LAWRENCE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5165
Mailing Address - Country:US
Mailing Address - Phone:773-588-7840
Mailing Address - Fax:773-588-0711
Practice Address - Street 1:3403 W LAWRENCE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5165
Practice Address - Country:US
Practice Address - Phone:773-588-7840
Practice Address - Fax:773-588-0711
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190194661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice