Healthcare Provider Details

I. General information

NPI: 1013275478
Provider Name (Legal Business Name): ROBERT GAROON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2012
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 GOLF RD
DES PLAINES IL
60016
US

IV. Provider business mailing address

9301 GOLF RD
DES PLAINES IL
60016-1667
US

V. Phone/Fax

Practice location:
  • Phone: 847-294-0080
  • Fax:
Mailing address:
  • Phone: 847-294-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME127128
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number036.146383
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: