Organization Active NPI

L Robert Warren MD LLC

  • Family Medicine Physician
  • Belvidere, IL
National Provider Identifier
1144424847
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
L ROBERT WARREN MD LLC
Practice address
205 Cadillac CT Ste 6
Belvidere, IL 61008-1733
Phone
(815) 544-0444
Fax
(815) 544-0652
NPI assigned
Jun 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Authorized official

Name
L Robert Warren, MD
Title
Pres
Phone
(815) 544-0444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

205 Cadillac CT Ste 6
Belvidere, IL 61008-1733

Mailing address

205 Cadillac CT Ste 6
Belvidere, IL 61008-1733
Phone (815) 544-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040816001153 IL Part B Supplier - Clinic/Group Practice 9739152992 Receives reassigned benefits from 1 practitioner
Practice locations: Belvidere, IL

National Provider Directory

National Provider Directory

Locations

1625 N State St
Belvidere, IL 61008
Phone (815) 547-5441

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1144424847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 CADILLAC CT STE 6",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081733",
            "telephone_number": "815-544-0444",
            "fax_number": "815-544-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 CADILLAC CT STE 6",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081733",
            "telephone_number": "815-544-0444",
            "fax_number": "815-544-0652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L ROBERT WARREN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "L  ROBERT",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "815-544-0444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.