Provider Demographics
NPI:1205856358
Name:WESTEFER, ROBERT ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ALAN
Last Name:WESTEFER
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 1:6915 N KNOXVILLE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-2850
Mailing Address - Country:US
Mailing Address - Phone:309-691-1259
Mailing Address - Fax:309-683-8911
Practice Address - Street 1:6915 N KNOXVILLE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-2850
Practice Address - Country:US
Practice Address - Phone:309-691-1259
Practice Address - Fax:309-683-8911
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0007223615OtherBCBS PROVIDER ID#
IL009045OtherHEALTH ALLIANCE PROVIDER
ILIL0102OtherJOHN DEERE PROVIDER ID#
IL166141OtherHEALTHLINK PROVIDER ID#
ILC45873Medicare UPIN
ILIL0102OtherJOHN DEERE PROVIDER ID#