Individual
DR. GEORGE ALBERT ROEBUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
113 E JEFFERSON ST, MORRIS, IL 60450-2101
(815) 942-1951
(815) 942-1958
Mailing address
113 E JEFFERSON ST, MORRIS, IL 60450-2101
(815) 942-1951
(815) 942-1958
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007227
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03084002
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/01/2006
Last updated
09/16/2014
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