| Dr Robert C Lichtenberg, MD | |
|
3231 Euclid Ave, Suite 201, Berwyn, IL 60402-3471 | |
| (708) 783-2055 | |
| (708) 783-2181 |
| Full Name | Dr Robert C Lichtenberg |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Cardiovascular Disease |
| Location | 3231 Euclid Ave, Berwyn, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013972850 | NPI | - | NPPES |
| 01621208 | Other | IL | BLUECROSS BLUE SHIELD |
| K10093 | Other | IL | MEDICARE INDIVIDUAL PTAN |
| 036068028 | Medicaid | IL | |
| 236551 | Other | IL | MEDICARE GROUP PTAN |
| 416810 | Other | IL | MEDICARE GROUP PTAN |
| R00334 | Other | IL | MEDICARE INDIVIDUAL PTAN |
| 236550 | Other | IL | MEDICARE GROUP PTAN |
| K10092 | Other | IL | MEDICARE INDIVIDUAL PTAN |
| 1508810086 | Other | IL | GROUP NPI |
| CD8033 | Other | IL | RAILROAD MEDICARE GROUP PTAN NUMBER |
| P00157668 | Other | IL | RAILROAD MEDICARE COOK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | 036068028 (Illinois) | Primary |
| 207R00000X | Internal Medicine | 036068028 (Illinois) | Secondary |
| Entity Name | Heart Care Centers Of Illinois, S.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508810086 PECOS PAC ID: 6103738810 Enrollment ID: O20031103000069 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Robert C Lichtenberg, MD 19001 Old Lagrange Rd, Mokena, IL 60448-8012 Ph: (708) 478-3600 | Dr Robert C Lichtenberg, MD 3231 Euclid Ave, Suite 201, Berwyn, IL 60402-3471 Ph: (708) 783-2055 |
Rekik Abebe Degef, Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 3231 Euclid Ave, Berwyn, IL 60402 Phone: 708-783-3401 Fax: 708-783-3341 | |
Dr. Mark L Goode, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 3231 Euclid Ave, Suite 405, Berwyn, IL 60402 Phone: 708-783-2644 Fax: 708-783-0514 | |
Mr. John D Brofman, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 3231 Euclid Ave, Berwyn, IL 60402 Phone: 815-463-8994 Fax: 815-463-8946 | |
Roberto J Gutierrez, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 3223 Harlem Ave, Berwyn, IL 60402 Phone: 708-484-1800 Fax: 708-484-1801 | |
Samantha Hu, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 3249 Oak Park Ave, Berwyn, IL 60402 Phone: 708-783-6566 | |
Sheena Reddy Kodavaluru, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 3249 Oak Park Ave, Macneal Hospital, Berwyn, IL 60402 Phone: 708-783-9100 |