Basic Information
| Provider Information | |||||||||
| NPI: | 1255315867 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LITCHFIELD | ||||||||
| FirstName: | ROBERT | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3615 PARK DR | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | OLYMPIA FIELDS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604611186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087489800 | ||||||||
| FaxNumber: | 7087489807 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 MACARTHUR BLVD | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | MUNSTER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463212915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087489800 | ||||||||
| FaxNumber: | 7087489807 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 03/09/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 02000573 | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 036054446 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.