Provider Demographics
NPI:1134117229
Name:KOJIMA, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:KOJIMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 EAST CARPENTER STREET
Mailing Address - Street 2:ROOM 2K64
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62769-0001
Mailing Address - Country:US
Mailing Address - Phone:217-525-5643
Mailing Address - Fax:217-544-2521
Practice Address - Street 1:800 EAST CARPENTER STREET
Practice Address - Street 2:ROOM 2K64
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62769-0001
Practice Address - Country:US
Practice Address - Phone:217-525-5643
Practice Address - Fax:217-544-2521
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL08415040OtherBLUE CROSS BLUE SHIELD
IL178785OtherHEALTHLINK UPIN#
IL085972OtherHEALTH ALLIANCE NUMBER
IL104409OtherHEALTHLINK GROUP NUMBER
IL32490OtherPERSONAL CARE
IL1285290Medicare ID - Type UnspecifiedMEDICARE UMWA#
IL08415040OtherBLUE CROSS BLUE SHIELD
ILP11996Medicare ID - Type UnspecifiedMEDICARE PART B
IL32490OtherPERSONAL CARE
IL779520Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER