Robin Andria Punsalan, M.D.
Individual provider Active NPI Pediatrics Physician · Byron, IL
NPI 1326367236 · NPPES record last updated Aug 16, 2013
Key facts
- NPI
- 1326367236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 0304 (MD)
- Practice address
- 109 N Franklin St
Byron, IL 61010-1441 - Phone
- (815) 234-3900
- NPI assigned
- May 18, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130722000051 | IL | Practitioner - Pediatric Medicine | 3971754763 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0304 | MD | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Current |
Accepting new patients | |
| Central Dupage Physician Group | Pediatrics | Current |
Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
Carol Stream, IL 60122
Phone (630) 933-3300
2900 Foxfield Rd
St Charles, IL 60174
Phone (630) 377-6500
2900 Foxfield Rd
Ste 200
St Charles, IL 60174
Phone (630) 377-7900
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0304 | MD | Yes |
Addresses
Primary practice location
109 N Franklin St
Byron, IL 61010-1441
Mailing address
109 N Franklin St
Byron, IL 61010-1441
Phone (815) 234-3900
Other providers in Byron, IL
- Ogle County Educ Coop
- Ogle County Physical Therapy Inc.
- Kush Patel
- Susan M Penner
- Angela Pfeiffer
- Shanairra C Quinn
- Rahn Family Wellness Center, LLC
- Troy A. Rahn
- RMJ Partnership
- Emily Rogers
All providers in Byron, IL · Pediatrics Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.