Individual
DR. ROBERT NORDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-6924
(217) 544-6464
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(309) 740-4272
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036105375
IL
2085R0202X
Diagnostic Radiology Physician
2009014887
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105375
—
IL
05
—
209331800
—
MO
Enumeration date
06/13/2006
Last updated
01/30/2024
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