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Organization

CRISTOBAL ROBLEDO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRISTOBAL ROBLEDO SURGICAL ASSISTANT (PRESIDENT)
(708) 577-9077
Entity
Organization

Contact information

Practice address
2900 W 102ND ST, EVERGREEN PARK, IL 60805-3553
(708) 577-9077
Mailing address
2900 W 102ND ST, EVERGREEN PARK, IL 60805-3553
(708) 577-9077

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238000484
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1104361930
I HAVE NOT USED
IL
Enumeration date
05/22/2018
Last updated
05/22/2018
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