Individual provider Active NPI

Robert B Love, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Warrenville, IL
National Provider Identifier
1336104041
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
036116543 Issued in IL
Practice address
4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone
(630) 938-8850
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 25340 WI
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X D90665 MD
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 036116543 IL Primary

Addresses

Primary practice location

4405 Weaver Pkwy
Warrenville, IL 60555-3269

Mailing address

4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 938-8850

Other practice location 1

12502 Willowbrook Rd
Cumberland, MD 21502-6491
Phone (240) 964-8724

Other identifiers 4

IdentifierTypeStateIssuer
31694000MedicaidWI
206147OtherILMEDICARE PTAN (GROUP)
1336104041MedicaidWI
F400206487OtherILMEDICARE PTAN (INDIVIDUAL)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MD, PA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20061128000397 IL Practitioner - Thoracic SurgeryPractitioner - Cardiovascular Disease (Cardiology) 9234182320 Reassigns benefits to 1 organization
I20210310001196 MD Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 9234182320 Reassigns benefits to 1 organization
I20210603002432 PA Practitioner - General SurgeryPractitioner - Thoracic Surgery 9234182320 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Western Maryland Corporation CurrentSince Mar 8, 2021 Accepting new patients
Central Dupage Physician Group CurrentSince Apr 1, 2015 Accepting new patients
Upmc Altoona Regional Health Services, Inc Current Accepting new patients
Central Dupage Physician Group CurrentSince Apr 1, 2015 Accepting new patients
Upmc Western Maryland Corporation Current Accepting new patients
Upmc Western Maryland Corporation CurrentSince Mar 8, 2021 Accepting new patients
Upmc Altoona Regional Health Services, Inc CurrentSince Apr 9, 2021 Accepting new patients
Upmc Western Maryland Health Services, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

4405 Weaver Pkwy
Warrenville, IL 60555
Phone (630) 352-5450

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

12502 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-8724

12502 Willowbrook Rd
Ste 470
Cumberland, MD 21502
Phone (240) 964-8724

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

1313 National Hwy
Lavale, MD 21502
Phone (240) 362-0288

1414 9th Ave
Altoona, PA 16602
Phone (814) 949-7621

Organizations & group practices 9

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1336104041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-938-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-938-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12502 Willowbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215026491",
            "country_code": "US",
            "telephone_number": "240-964-8724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVE",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WI",
            "license": "25340",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MD",
            "license": "D90665",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036116543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31694000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "206147",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336104041",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "F400206487",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.