Active NPI
Robert Matthew Golub, M.D.
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1295859189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Practice address
- 675 N Saint Clair St
Suite 18-200
Chicago, IL 60611-5975 - Phone
- (312) 695-8630
- NPI assigned
- Mar 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | IL | Primary |
Addresses
Primary practice location
675 N Saint Clair St
Suite 18-200
Chicago, IL 60611-5975
Mailing address
500 W Barry Ave
#3E
Chicago, IL 60657-5422
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-065821 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295859189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W BARRY AVE",
"address_2": "#3E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606575422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 N SAINT CLAIR ST",
"address_2": "SUITE 18-200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606115975",
"telephone_number": "312-695-8630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLUB",
"first_name": "ROBERT",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.