Individual
DR. ROBERT KIPPENBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250
Mailing address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008481
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039087
HEALTH ALLIANCE
—
05
—
046008481
—
IL
01
—
0814870001
MEDICARE NSC NUMBER
IL
01
—
0814870007
MEDICARE NSC NUMBER
IL
01
—
0814870008
MEDICARE NSC NUMBER
IL
01
—
0814870021
MEDICARE NSC NUMBER
IL
01
—
0814870022
MEDICARE NSC NUMBER
IL
01
—
236231
HARMONY HEALTH PLAN
—
01
—
401129393
MEDICARE RAILROAD
IL
01
—
IL8481
EYEMED
—
Enumeration date
05/16/2006
Last updated
02/03/2012
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