Provider Demographics
NPI:1770762536
Name:ROBERT J. DUCH M.D.S.C.
Entity type:Organization
Organization Name:ROBERT J. DUCH M.D.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-230-0277
Mailing Address - Street 1:1813 EATON DR
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-4612
Mailing Address - Country:US
Mailing Address - Phone:630-230-0277
Mailing Address - Fax:630-541-6915
Practice Address - Street 1:121 N ELM ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3765
Practice Address - Country:US
Practice Address - Phone:630-230-0277
Practice Address - Fax:630-541-6915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01626862OtherBCBS OF ILLINOIS
ILDG5714OtherMEDICARE RAILROAD
IL587920Medicare PIN
ILE42512Medicare UPIN