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Contact Information

ROBERT G CARNEY JR, MD
1770 E LAKE SHORE DR
SUITE #301
DECATUR, IL62521-3832
 Phone: 217-429-2636
 Fax: 217-429-2687
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for ROBERT G CARNEY JR · (Male)

NPI Number 1275598542
Status Active
Credentials MD
Entity Individual
Enumeration date 04/19/2006
Last updated 01/08/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036-049753
  • IL Medicaid 036049753
  • IL Other 00882 PAYER ID
  • IL Other 071128778 RR MEDICARE PROVIDER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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