Provider Demographics
NPI:1043355530
Name:ZIMMERMAN, ROBERT D (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 ERIE CT
Mailing Address - Street 2:SUITE 4030
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2566
Mailing Address - Country:US
Mailing Address - Phone:708-386-7888
Mailing Address - Fax:708-386-2784
Practice Address - Street 1:1 ERIE CT
Practice Address - Street 2:SUITE 4030
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2566
Practice Address - Country:US
Practice Address - Phone:708-386-7888
Practice Address - Fax:708-386-2784
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036054963208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036054963Medicaid
IL036054963Medicaid
ILD93399Medicare UPIN
IL2070320013Medicare PIN
ILL52710Medicare PIN
ILF400326716Medicare PIN