Provider Demographics
NPI:1992852925
Name:SHULMAN, ROBERT B (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1645 W JACKSON BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-2847
Mailing Address - Country:US
Mailing Address - Phone:312-942-5372
Mailing Address - Fax:312-942-4224
Practice Address - Street 1:1645 W JACKSON BLVD STE 600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-2847
Practice Address - Country:US
Practice Address - Phone:312-942-5372
Practice Address - Fax:312-942-4224
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-0785812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE39347Medicare UPIN