Provider Demographics
NPI:1811421514
Name:CROSBIE, ROBERT R (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:CROSBIE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E BLUFF VIEW DR UNIT 80
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-8908
Mailing Address - Country:US
Mailing Address - Phone:773-766-7081
Mailing Address - Fax:331-336-5644
Practice Address - Street 1:2501 CHATHAM RD STE R
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-4188
Practice Address - Country:US
Practice Address - Phone:773-766-7081
Practice Address - Fax:331-336-5644
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME165629208D00000X
AZ68132208D00000X
UT11809435-1205208D00000X
NM390200000X
IL036.163255208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program