Individual provider Active NPI

Robert C Munson Jr., MD

  • Internal Medicine Physician
  • Northbrook, IL
National Provider Identifier
1609872373
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036053778 Issued in IL
Practice address
770 Skokie Blvd Unit 606
Northbrook, IL 60062-2352
Phone
(847) 970-1469
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036053778 IL Primary

Addresses

Primary practice location

770 Skokie Blvd Unit 606
Northbrook, IL 60062-2352

Mailing address

770 Skokie Blvd Unit 606
Northbrook, IL 60062-2352
Phone (847) 970-1469

Other identifiers 1

IdentifierTypeStateIssuer
036053778MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20091125000604 IL Practitioner - Internal Medicine 4486793767 Practice locations: Libertyville, IL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036053778ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1609872373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 SKOKIE BLVD UNIT 606",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622352",
            "telephone_number": "847-970-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 SKOKIE BLVD UNIT 606",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622352",
            "telephone_number": "847-970-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNSON",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036053778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053778",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.