Healthcare Provider Details

I. General information

NPI: 1003911991
Provider Name (Legal Business Name): KAREN L. ROBERT P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 N MAPLE ST
EFFINGHAM IL
62401-2005
US

IV. Provider business mailing address

900 W TEMPLE AVE STE 106
EFFINGHAM IL
62401-2186
US

V. Phone/Fax

Practice location:
  • Phone: 217-347-7030
  • Fax: 217-347-7049
Mailing address:
  • Phone: 217-347-2707
  • Fax: 217-347-2827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: