Provider Demographics
NPI:1053416248
Name:NATONSON, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:NATONSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:625 ROGER WILLIAMS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-4840
Mailing Address - Country:US
Mailing Address - Phone:847-433-3460
Mailing Address - Fax:847-433-4062
Practice Address - Street 1:625 ROGER WILLIAMS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-4840
Practice Address - Country:US
Practice Address - Phone:847-433-3460
Practice Address - Fax:847-433-4062
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD14755Medicare UPIN