Provider Demographics
NPI:1255548202
Name:DR. ROBERT L. BARON
Entity type:Organization
Organization Name:DR. ROBERT L. BARON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:630-554-1450
Mailing Address - Street 1:60 MAIN ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8594
Mailing Address - Country:US
Mailing Address - Phone:630-554-1450
Mailing Address - Fax:630-554-5101
Practice Address - Street 1:60 MAIN ST.
Practice Address - Street 2:SUITE A
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8594
Practice Address - Country:US
Practice Address - Phone:630-554-1450
Practice Address - Fax:630-554-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213EP1101X, 213ER0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Not Answered213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL679250Medicare ID - Type Unspecified
ILT37002Medicare UPIN