Provider Demographics
NPI:1629418132
Name:ROBERT W. BURTON, MD, INC.
Entity Type:Organization
Organization Name:ROBERT W. BURTON, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-203-3253
Mailing Address - Street 1:1274 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1638
Mailing Address - Country:US
Mailing Address - Phone:312-203-3253
Mailing Address - Fax:847-595-8353
Practice Address - Street 1:1274 TOWER RD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-1638
Practice Address - Country:US
Practice Address - Phone:312-203-3253
Practice Address - Fax:847-595-8353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036072613261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health