Provider Demographics
NPI:1255315867
Name:LITCHFIELD, ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:LITCHFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3615 PARK DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1186
Mailing Address - Country:US
Mailing Address - Phone:708-748-9800
Mailing Address - Fax:708-748-9807
Practice Address - Street 1:801 MACARTHUR BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2915
Practice Address - Country:US
Practice Address - Phone:708-748-9800
Practice Address - Fax:708-748-9807
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02000573207RC0000X
IL036054446207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC44959Medicare UPIN
IN406090AMedicare PIN
IN406310CMedicare PIN