Robert A Wiltz, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071001790 Issued in IL

Practice address

1401 Lakewood Dr
Suite a
Morris, IL 60450-3352

Phone

(815) 942-6323

Fax

(815) 942-6423

NPI assigned

Jun 10, 2006

Last updated

Dec 20, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1568403236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 LAKEWOOD DR",
            "address_2": "SUITE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503352",
            "telephone_number": "815-942-6323",
            "fax_number": "815-942-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 LAKEWOOD DR",
            "address_2": "SUITE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604503352",
            "telephone_number": "815-942-6323",
            "fax_number": "815-942-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTZ",
        "first_name": "ROBERT",
        "middle_name": "A",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071001790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenn C Willareth, DC
• Robert Charles Williams, M.D.
• Wesley J Williams, P.T.
• John Ellis Williamson Jr., D.O.
• Kristin Leigh Williford, AUD
• Margaret Wingate
• Hershel L Wix Jr., M.D.
• Jessica Woodward, PT, DPT
• Bonnie Lynn Yale, DMD
• Mark David Zenke, MSN APRN FNP-C

• Psychologist in Morris, IL
• Providers in Morris, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.