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Individual

MRS. CANDICE ROSE ROBB-RAREY

Active
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Individual

MRS. CANDICE ROSE ROBB-RAREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036128471
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036128471
IL
01
920540
MEDICARE PTAN (GROUP)
IL
01
920540029
MEDICARE PTAN (INDIVIDUAL)
IL
01
DB1658
RR MEDICARE PTAN (GROUP)
IL
01
P01098968
RR MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
04/10/2009
Last updated
07/23/2013
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