Healthcare Provider Details

I. General information

NPI: 1750360764
Provider Name (Legal Business Name): JON A ROBKEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 E RUSHOLME ST SUITE 300
DAVENPORT IA
52803-2473
US

IV. Provider business mailing address

1236 E RUSHOLME ST
DAVENPORT IA
52803-2434
US

V. Phone/Fax

Practice location:
  • Phone: 563-324-2992
  • Fax: 563-888-0499
Mailing address:
  • Phone: 563-324-2992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number21068
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier060021825
Identifier TypeOTHER
Identifier State
Identifier IssuerMEDICARE RAILROAD
# 2
Identifier2025700
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: