Provider Demographics
NPI:1699877175
Name:LORBER, DAVID A (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:LORBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9711 SKOKIE BLVD
Mailing Address - Street 2:SUITE J
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1384
Mailing Address - Country:US
Mailing Address - Phone:847-675-9711
Mailing Address - Fax:847-675-9714
Practice Address - Street 1:9711 SKOKIE BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1384
Practice Address - Country:US
Practice Address - Phone:847-675-9711
Practice Address - Fax:847-675-9714
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-066262207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC45963Medicare UPIN
ILL31093Medicare ID - Type Unspecified
ILIL2485001Medicare PIN