Active NPI
Robert Joseph Signore, DO
- Dermatology Physician
- Tinley Park, IL
National Provider Identifier
1346306776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Practice address
- 17730 S Oak Park Avenue
Suite C
Tinley Park, IL 60477 - Phone
- (708) 429-2992
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 5101009559 | MI | |
| Dermatology Physician | 207N00000X | IL | Primary |
Addresses
Primary practice location
17730 S Oak Park Avenue
Suite C
Tinley Park, IL 60477
Mailing address
17730 S Oak Park Avenue
Suite C
Tinley Park, IL 60477
Phone (708) 429-2992
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31604116 | Other | IL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2001 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101009559 | MI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346306776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17730 S OAK PARK AVENUE",
"address_2": "SUITE C",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "60477",
"telephone_number": "708-429-2992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17730 S OAK PARK AVENUE",
"address_2": "SUITE C",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "60477",
"telephone_number": "708-429-2992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIGNORE",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "5101009559",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "31604116",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.