Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRADFORD C ROBERG, M.D.
Deactivated Sole ProprietorBRADFORD C ROBERG, M.D. is a Plastic and Reconstructive Surgery healthcare provider located in CRYSTAL LAKE, Illinois. NPI 1316946072 is deactivated in the NPPES registry. Verify at CMS.
Plastic and Reconstructive Surgery · CRYSTAL LAKE, IL
This NPI has been deactivated.
The record was deactivated on March 18, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1316946072
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 15, 2005 (0.67397260273973 yrs)
- Last Updated
- Jul 8, 2007
- Deactivated
- Mar 18, 2006
- Sole Proprietor
- Yes
Practice Information
- Address
-
5714 S STATE ROUTE 31CRYSTAL LAKE, IL, 600144520Browse IL providers · Browse ZIP 60014
- Phone
- 8153567000
- Fax
- 8153567513
- Primary Specialty
-
Plastic and Reconstructive Surgery
2086S0122X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.