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NPI Code Detail

MEDICARE: ROBERT W BASTIAN MD

MEDICARE:   ROBERT W BASTIAN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician036059793IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184713455
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT W BASTIAN MD
Provider Business Mailing Address
First Line : 3010 HIGHLAND PKWY STE 250
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5545
Country : US
Telephone Number : 630-724-1100
Fax Number : 630-724-0084
Provider Business Practice Location Address
First Line : 3010 HIGHLAND PKWY STE 250
Second Line :
City : DOWNERS GROVE
State : IL
Zip : 60515-5545
Country : US
Telephone Number : 630-724-1100
Fax Number : 630-724-0084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 11/14/2025

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