Individual
DR. ROBERT GERARD KUMMERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
890 GARFIELD AVE, SUITE 101, LIBERTYVILLE, IL 60048-4723
(847) 990-5636
(847) 367-1535
Mailing address
9500 BORMET DR STE 204, MOKENA, IL 60448-8399
(708) 346-4040
(708) 346-3287
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036087848
IL
2086S0129X
Vascular Surgery Physician
036087848
IL
2086S0129X
Vascular Surgery Physician
55253-20
WI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036087848
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
55253-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BCBS
IL
05
—
036087848
—
IL
05
—
1902891674
—
WI
05
—
200269890A
—
IN
05
—
200269890B
—
IN
Enumeration date
09/19/2005
Last updated
12/17/2021
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