MEDICARE: DR. ROBERT I(SA) PFEFFER M.D.

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
1	2084N0400X	Neurology Physician	G19638	CA
2	2084N0400X	Neurology Physician	029918	OH
3	2084N0400X	Neurology Physician	16797	CO
4	2084N0400X	Neurology Physician		IL

General Provider Information

NPI Number	:	1073503819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT I(SA) PFEFFER M.D.

Provider Business Mailing Address
First Line	:	3323 W GLOUCESTER CT
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61615-2601
Country	:	US
Telephone Number	:	309-692-5462
Fax Number	:

Provider Business Practice Location Address
First Line	:	3323 W GLOUCESTER CT
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61615-2601
Country	:	US
Telephone Number	:	309-692-5462
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	04/12/2026

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