DR. ROBERT J BORN (NPI# 1134170590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134170590 |
| Entity Type | Individual |
| Full Name | DR. ROBERT J BORN |
| Credential | DPM |
| Practice Address |
1802 S. Mattis Avenue Orthopedics Champaign IL 61821 |
| Mailing Address |
P.o. Box 6002 Urbana IL 61803-6002 |
| Practice Telephone | 2173837676 |
| Practice Fax Number | 2173834910 |
| Mailing Telephone | 2173268300 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2013-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 016-003180 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DMERC | 0533210001 | 01 |
| IL | 016-003180 | 05 |
| Street Address |
1802 S. MATTIS AVENUE ORTHOPEDICS |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255310629 | Hyunchul Jung | Anesthesiology | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2006-01-12 |
| 1669616611 | Katherine Stout | Nurse Practitioner | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2009-04-21 |
| 1881807642 | Shabeera Rauther | Anesthesiology | 1802 S. Mattis Avenue, Pain Center, Champaign, IL 61821 | 2007-05-08 |
| 1033276324 | Julie A Young | Physician Assistant | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2007-01-03 |
| 1528146883 | James Berkes | Physician Assistant | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2006-11-02 |
| 1982704102 | James K Sobeski | Orthopaedic Surgery | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2006-09-25 |
| 1770698789 | Brian J Cummings | Physician Assistant | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2006-08-20 |
| 1043230089 | Phillip K Logsdon | Podiatrist | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2006-07-20 |
| 1134147200 | Kenneth J Dols | Orthopaedic Surgery | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2006-07-17 |
| 1578589834 | Scott V Kline | Orthopaedic Surgery | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2006-07-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
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| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811903651 | Kimberly M. Eickmeier | Podiatrist | 411 Devonshire Dr, Champaign, IL 61820-7286 | 2006-08-01 |
| 1568459030 | Bart Wayne Gastwirth | Podiatrist | 1802 S Mattis Ave, Champaign, IL 61821-5923 | 2005-09-30 |
| 1841517679 | Lisa Ryan Hobbs | Podiatrist | 3101 Fields South Dr, Champaign, IL 61822-3743 | 2010-05-04 |
| 1063566727 | Sarah Spizzirri | Podiatrist | 1801 Windsor Rd, Podiatry Department, Champaign, IL 61822-6217 | 2007-01-22 |
| 1063420461 | William L. Pierce Jr. | Podiatrist | 1801 Windsor Rd, Champaign, IL 61822-6217 | 2006-08-03 |
| 1043230089 | Phillip K Logsdon | Podiatrist | 1802 S. Mattis Avenue, Orthopedics, Champaign, IL 61821 | 2006-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200343 | Podiatric Management Systems LLC | Podiatrist | 1 S067 Summit Ave, Oakbrook Terrace, IL 60181 | 2020-09-21 |
| 1114533700 | Podiatric Management Systems LLC | Podiatrist | 537 W 31st St, Chicago, IL 60616-3294 | 2020-09-18 |
| 1306452099 | Podiatric Management Systems LLC | Podiatrist | 2 W Talcott Rd Ste 23, Park Ridge, IL 60068-5558 | 2020-09-18 |
| 1073129763 | Podiatric Management Systems LLC | Podiatrist | 4310f W Crystal Lake Rd # F, Mchenry, IL 60050-4208 | 2020-09-18 |
| 1679187090 | Podiatric Management Systems LLC | Podiatrist | 5600 W Addison St Lowr 2ll, Chicago, IL 60634-4499 | 2020-09-02 |
| 1932742848 | Foot and Ankle Care & Associates, Ltd | Podiatrist | 3320 W 63rd St, Chicago, IL 60629-3317 | 2019-10-23 |
| 1437622966 | Tomasz Szmyd Dpm, PC | Podiatrist | 1500 E 67th St, Chicago, IL 60637-4427 | 2019-01-08 |
| 1689145898 | S Thomas Sehy D P M L L C | Podiatrist | 213 Nw 10th St Ste B, Fairfield, IL 62837-1219 | 2018-12-16 |
| 1548746761 | Jeremy Marchand | Podiatrist | 2751 W Winona St Rm Ap457, Chicago, IL 60625-2508 | 2018-07-11 |
| 1932693744 | Giovanni Incandela | Podiatrist | 700 E Algonquin Rd Unit 2313, Schaumburg, IL 60173-3835 | 2018-06-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.