Individual
SAMUEL R EBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7836 W JEFFERSON BLVD STE 100, FORT WAYNE, IN 46804-4165
(260) 494-3484
(260) 969-0188
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 575-5000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01032985
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100085970
—
IN
Enumeration date
05/16/2006
Last updated
11/16/2020
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