Robert Vincent Kolbusz, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

036-070368 Issued in IL

Practice address

2500 S Highland Ave
Lombard, IL 60148-5363

Phone

(630) 964-2000

Fax

(630) 964-6378

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1669403457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S HIGHLAND AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485363",
            "telephone_number": "630-964-2000",
            "fax_number": "630-964-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S HIGHLAND AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485363",
            "telephone_number": "630-964-2000",
            "fax_number": "630-964-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLBUSZ",
        "first_name": "ROBERT",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": "036-070368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolene Knudson
• Cori Knutson, APN
• Ko Surgical Associates P.C
• Sung-Tao Ko, M.D.
• Jay Gerald Kolb, DDS
• John Komperda
• Konrad Kordylasinski, M.S., BCBA
• Yuri Korvatko, DC
• David Kosar
• Desirae Kotnik, RN

• MOHS-Micrographic Surgery Physician in Lombard, IL
• Providers in Lombard, IL by specialty
• MOHS-Micrographic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.