Individual provider Active NPI

Robert Louis Heilbronner, PH.D.

  • Clinical Neuropsychologist
  • Chicago, IL
National Provider Identifier
1306993068
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071-003907 Issued in IL
Practice address
333 N Michigan Ave
Suite 1801
Chicago, IL 60601-3901
Phone
(312) 345-0933
Fax
(312) 345-0934
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 071-003907 IL Primary

Addresses

Primary practice location

333 N Michigan Ave
Suite 1801
Chicago, IL 60601-3901

Mailing address

333 N Michigan Ave
Suite 1801
Chicago, IL 60601-3901
Phone (312) 345-0933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120627000098 IL Practitioner - Clinical Psychologist 6406011394 Practice locations: Chicago, IL; Evergreen Park, IL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
071-003907ILMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert L Heilbronner, PHD Clinical Neuropsychologist PastSince Dec 2, 2015 Accepting new patients

Organizations & group practices 1

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306993068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE",
            "address_2": "SUITE 1801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606013901",
            "telephone_number": "312-345-0933",
            "fax_number": "312-345-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N MICHIGAN AVE",
            "address_2": "SUITE 1801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606013901",
            "telephone_number": "312-345-0933",
            "fax_number": "312-345-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILBRONNER",
        "first_name": "ROBERT",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071-003907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.