Provider Demographics
NPI:1831312131
Name:BURTON, ROBERT WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:BURTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1638
Mailing Address - Country:US
Mailing Address - Phone:312-203-3253
Mailing Address - Fax:847-595-8353
Practice Address - Street 1:1274 TOWER RD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-1638
Practice Address - Country:US
Practice Address - Phone:312-203-3253
Practice Address - Fax:847-595-8353
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360726132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD16716Medicare UPIN
IL787540Medicare ID - Type Unspecified