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Individual

DR. ROBERT CARL JESPERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
625 SLAWIN CT, MOUNT PROSPECT, IL 60056-2183
(847) 789-7155
(847) 789-7161
Mailing address
5701 N SHERIDAN RD, #28-S, CHICAGO, IL 60660-4771
(773) 989-5429

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036070086
IL
208D00000X
General Practice Physician
036070086
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001627310
BCBS
IL
05
036070086
IL
01
F300267780
PTAN
IL
Enumeration date
10/23/2006
Last updated
02/22/2019
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