Organization
MIDWEST PEDIATRIC CARDIOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ROBERSON MD (PRESIDENT)
(708) 684-5580
Entity
Organization
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5580
(708) 684-4068
Mailing address
621 PLAINFIELD RD, #105, WILLOW BROOK, IL 60527-5343
(630) 321-9811
(630) 321-9813
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617609
BCBS OF ILLINOIS
—
Enumeration date
11/09/2005
Last updated
09/14/2007
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