MEDICARE: DR. ROBERT MARSHALL 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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	036-106479	IL
2	207R00000X	Internal Medicine Physician	036-106479	IL
3	207P00000X	Emergency Medicine Physician	36698	MS
4	207P00000X	Emergency Medicine Physician	036-106479	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	036106479	OTHER	IL	BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316031396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MARSHALL MD

Provider Business Mailing Address
First Line	:	6600 WEST RAVEN STREET
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-2506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6660 W RAVEN ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-2506
Country	:	US
Telephone Number	:	773-774-5702
Fax Number	:

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	03/11/2026

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Directions to “ DR. ROBERT MARSHALL MD” Practice Location

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