Individual provider Active NPI

Robert D Zimmerman, M.D.

  • Urology Physician
  • Oak Park, IL
National Provider Identifier
1043355530
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036054963 Issued in IL
Practice address
1 Erie CT
Suite 4030
Oak Park, IL 60302-2566
Phone
(708) 386-7888
Fax
(708) 386-2784
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036054963 IL Primary

Addresses

Primary practice location

1 Erie CT
Suite 4030
Oak Park, IL 60302-2566

Mailing address

1 Erie CT
Suite 4030
Oak Park, IL 60302-2566
Phone (708) 386-7888

Other identifiers 1

IdentifierTypeStateIssuer
036054963MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070914000479 IL Practitioner - Urology 6800980343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Chicago Surgical Oncology LLCGroup PAC ID 7214107069, 13 clinicians

Practice addresses (Care Compare)

1 Erie CT
Suite 4030
Oak Park, IL 60302-2510
Phone (708) 386-7888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
United Shockwave Services, LTD. CurrentSince May 1, 1996 Accepting new patients
United Shockwave Services, LTD. Urology CurrentSince May 1, 1996 Accepting new patients

Locations

1875 W Dempster St
Ste G04
Park Ridge, IL 60068
Phone (630) 684-9361

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

6701 159th St
Tinley Park, IL 60477
Phone (708) 429-0222

Interoperability endpoints

  • Direct secure messaging: robert.zimmerman.1@3164.direct.athenahealth.com
  • Direct secure messaging: robert.zimmerman.2@3164.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1043355530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ERIE CT",
            "address_2": "SUITE 4030",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022566",
            "telephone_number": "708-386-7888",
            "fax_number": "708-386-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ERIE CT",
            "address_2": "SUITE 4030",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022566",
            "telephone_number": "708-386-7888",
            "fax_number": "708-386-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "ROBERT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036054963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054963",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.