Provider Demographics
NPI:1053760355
Name:KASPER, ROBERT JAMES (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:KASPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4203
Mailing Address - Country:US
Mailing Address - Phone:630-938-3300
Mailing Address - Fax:630-938-3310
Practice Address - Street 1:298 RANDALL RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4203
Practice Address - Country:US
Practice Address - Phone:630-938-3300
Practice Address - Fax:630-938-3310
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125168104390200000X
IL036148038207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program