Robert Edward Olt

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.008386 Issued in IL

Practice address

588 S Plum St
Havana, IL 62644-1374

Phone

(309) 253-7611

NPI assigned

Jan 29, 2014

Last updated

Jan 29, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Robert Olt Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1386067213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 S PLUM ST",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441374",
            "telephone_number": "309-253-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 S PLUM ST",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441374",
            "telephone_number": "309-253-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLT",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "OLT",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mason Hospital District (Mason District Hospital)
• Kayla R Miller, M.D.
• Nathan Lee Moehring, PHARM D
• Cynthia Carol Noll, C-FNP
• Stanley Jay Noll, MD
• Pam Herrick Counseling, S.C.
• Petersen Health Care Inc (Havana Health Care Center)
• Jessica Poling, IBCLC
• Donald Quinones
• Ronald Paul Quinones, PHARMD

• Clinical Psychologist in Havana, IL
• Providers in Havana, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.