Active NPI
Robert Wochner, MD
- Family Medicine Physician
- Mattoon, IL
National Provider Identifier
1164538864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036-082126
- Practice address
- 1005 Health Center Drive
Suite 103
Mattoon, IL 61938 - Phone
- (217) 258-4051
- Fax
- (217) 258-4063
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-082126 | IL | Primary |
Addresses
Primary practice location
1005 Health Center Drive
Suite 103
Mattoon, IL 61938
Mailing address
1005 Health Center Drive
Suite 103
Mattoon, IL 61938
Phone (217) 258-4051
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-082126 | IL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302652800000",
"number": "1164538864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 HEALTH CENTER DRIVE",
"address_2": "SUITE 103",
"city": "MATTOON",
"state": "IL",
"postal_code": "61938",
"telephone_number": "217-258-4051",
"fax_number": "217-258-4063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 HEALTH CENTER DRIVE",
"address_2": "SUITE 103",
"city": "MATTOON",
"state": "IL",
"postal_code": "61938",
"telephone_number": "217-258-4051",
"fax_number": "217-258-4063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOCHNER",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2011-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-082126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattoon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.