Provider Demographics
NPI:1003954066
Name:KOHN, ROBERT G (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:KOHN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5404 W ELM ST
Mailing Address - Street 2:STE Q
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-4007
Mailing Address - Country:US
Mailing Address - Phone:815-344-0020
Mailing Address - Fax:
Practice Address - Street 1:649 RIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-7012
Practice Address - Country:US
Practice Address - Phone:815-344-7951
Practice Address - Fax:815-759-3807
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0838102084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5626836OtherBCBS-NEUROLOGY
IL374380Medicare ID - Type Unspecified
ILC50914Medicare UPIN