Childers, Robert D

Childers, Robert D is an sole proprietor health care provider with primary practice located at 400 Maple Summit Rd Ste 300, Jerseyville IL 62052-2028. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Childers, Robert D can be contacted via phone (618) 498-8470.

Contact Information

Primary practice address
400 Maple Summit Rd Ste 300 Jerseyville IL 62052-2028
Phone: (618) 498-8470
Fax: (618) 498-8488
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 01093287A Indiana
Allopathic & Osteopathic Physicians / Urology 208800000X 036073486 Illinois

Profile Details

NPI number 1760477376
LBN Legal business name Childers, Robert D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2005
Last updated Apr 15th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760477376 NPPES
Illinois MEDICAID 036073486
Illinois Other 2822
Illinois Other 0006000528
Illinois Other 340014235

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