Provider Demographics
NPI:1538156294
Name:CZEPIEL, ROBERT S (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:CZEPIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 95TH ST
Mailing Address - Street 2:STE 105
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-7802
Mailing Address - Country:US
Mailing Address - Phone:630-646-6920
Mailing Address - Fax:630-646-6925
Practice Address - Street 1:2007 95TH ST
Practice Address - Street 2:STE 105
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-7802
Practice Address - Country:US
Practice Address - Phone:630-646-6920
Practice Address - Fax:630-646-6925
Is Sole Proprietor?:No
Enumeration Date:2005-09-28
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036096075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036096075 2Medicaid
IL2222385OtherBCBS
G95097Medicare UPIN
IL2222385OtherBCBS
IL036096075 2Medicaid