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Individual
DR. ROBERT J S MACK
Active
Individual
DR. ROBERT J S MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. P C
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036-090403
IL
207W00000X
Ophthalmology Physician
Primary
036090403
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6046380001
NATIONAL GOVERNMENT SERVICES
IL
Enumeration date
07/13/2005
Last updated
12/28/2022
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