Provider Demographics
NPI:1023702909
Name:MOROBE, RORISANG PHEKU (MD)
Entity type:Individual
Prefix:DR
First Name:RORISANG
Middle Name:PHEKU
Last Name:MOROBE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RORISANG
Other - Middle Name:ROSINA
Other - Last Name:PHEKU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6700 S OGLESBY AVE APT 2306
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1386
Mailing Address - Country:US
Mailing Address - Phone:319-651-9396
Mailing Address - Fax:
Practice Address - Street 1:1625 E 75TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-3603
Practice Address - Country:US
Practice Address - Phone:773-947-7313
Practice Address - Fax:773-947-2487
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.082097207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine