Provider Demographics
NPI:1679589717
Name:HARDEN, ROBERT NORMAN (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:NORMAN
Last Name:HARDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 N MICHIGAN AVE
Mailing Address - Street 2:STE. 800
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4501
Mailing Address - Country:US
Mailing Address - Phone:312-238-7800
Mailing Address - Fax:312-238-7801
Practice Address - Street 1:980 N MICHIGAN AVE
Practice Address - Street 2:STE. 800
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4501
Practice Address - Country:US
Practice Address - Phone:312-238-7800
Practice Address - Fax:312-238-7801
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0874012081P2900X, 2084N0400X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL250011898OtherRAILROAD MEDICARE
IL250011899OtherRAILROAD MEDICARE
IL036087401Medicaid
ILL76333Medicare PIN
IL250011899OtherRAILROAD MEDICARE
ILL76488Medicare PIN