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Organization
ROBERT OWENS MD CORPORATION
Active
Organization
ROBERT OWENS MD CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT OWENS M.D. (PHYSICIAN OWNER)
(312) 497-0772
Entity
Organization
Contact information
Practice address
326 W 64TH ST, CHICAGO, IL 60621-3114
(312) 497-0772
(773) 955-3020
Mailing address
5139 S WOODLAWN AVE, CHICAGO, IL 60615-3901
(312) 497-0772
(773) 955-6050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036053016
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02201400
BLUE CROSS OF ILLINOIS
—
05
—
036053016
—
IL
Enumeration date
11/20/2008
Last updated
04/01/2009
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