Provider Demographics
NPI:1710787643
Name:CROONBORG, ROB (MES)
Entity type:Individual
Prefix:
First Name:ROB
Middle Name:
Last Name:CROONBORG
Suffix:
Gender:
Credentials:MES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 WINNETKA TER
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2165
Mailing Address - Country:US
Mailing Address - Phone:847-951-3949
Mailing Address - Fax:
Practice Address - Street 1:850 S ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2828
Practice Address - Country:US
Practice Address - Phone:847-951-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner