Provider Demographics
NPI:1730128026
Name:HILL, ROBERT (MS, ATC, L)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:MS, ATC, L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 135
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IL
Mailing Address - Zip Code:61727-9524
Mailing Address - Country:US
Mailing Address - Phone:217-937-1138
Mailing Address - Fax:
Practice Address - Street 1:1900 E LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62521-3824
Practice Address - Country:US
Practice Address - Phone:217-428-6222
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer