Active NPI
Robert D Quevillon, MD
- Internal Medicine Physician
- Joliet, IL
National Provider Identifier
1346528486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036.106715
- Practice address
- 213 E Cass St
Joliet, IL 60432-2812 - Phone
- (815) 726-3377
- NPI assigned
- Jul 22, 2011
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036.106715 | IL | Primary |
Addresses
Primary practice location
213 E Cass St
Joliet, IL 60432-2812
Mailing address
204 Illini Dr
Minooka, IL 60447
Phone (815) 521-0601
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 |
|---|---|---|---|
| 036.106715 | IL | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1346528486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 ILLINI DR",
"city": "MINOOKA",
"state": "IL",
"postal_code": "60447",
"telephone_number": "815-521-0601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 E CASS ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604322812",
"telephone_number": "815-726-3377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEVILLON",
"first_name": "ROBERT",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-22",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036.106715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.