Provider Demographics
NPI:1164592432
Name:LANGMAN, ROBERT E (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:LANGMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-3315
Mailing Address - Country:US
Mailing Address - Phone:630-315-6700
Mailing Address - Fax:630-315-6699
Practice Address - Street 1:552 RANDALL RD
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-3315
Practice Address - Country:US
Practice Address - Phone:630-315-6700
Practice Address - Fax:630-315-6699
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-077898207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL110101777OtherRAILROAD MEDICARE
IL920540OtherMEDICARE PTAN (GROUP)
ILDB1658OtherRAIL ROAD MEDICARE PTAN (GROUP)
IL920540024OtherMEDICARE PTAN (INDIVIDUAL)
IL036077898Medicaid
ILP01051854OtherRAIL ROAD MEDICARE PTAN (INDIVIDUAL)
ILD16775Medicare UPIN
IL036077898Medicaid