ROBERT LEO BLACK JR. (NPI# 1528084472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528084472 |
| Entity Type | Individual |
| Full Name | ROBERT LEO BLACK JR. |
| Credential | M.D. |
| Practice Address |
1400 W Park St Urbana IL 61801-2334 |
| Mailing Address |
75 Remitt Drive Lockbox 6053 Chicago IL 60675-6053 |
| Practice Telephone | 2173372000 |
| Mailing Telephone | 8669165259 |
| Mailing Fax Number | 2319224030 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-12-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 036-085333 | IL | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 34824-020 | WI | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | J6877 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036085333 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336624535 | Robert G Black Sr. | Physical Therapist | 3550 Harrison Blvd Ste D, Ogden, UT 84403-2081 | 2018-10-03 |
| 1629583471 | Robert D Black | Counselor | 2569 Lakefield Trl, Marietta, GA 30064-5764 | 2017-12-01 |
| 1285039735 | Robert Black | Hearing Instrument Specialist | 1012 Gay St, Portsmouth, OH 45662-3456 | 2014-10-27 |
| 1538434097 | Robert Clint Black | Registered Nurse | 1169 Broderick Rd, Omro, WI 54963-1091 | 2012-03-16 |
| 1013186246 | Robert Black | Chiropractor | 1270 5th Ave Apt 5t, New York, NY 10029-3421 | 2008-02-21 |
| 1457499428 | Robert Grant Black | Specialist | 285 Vista Drive, Suite A, Pocatello, ID 83201 | 2007-02-02 |
| 1134107576 | Robert Michael Black | Family Medicine | 40 Okatie Center Blvd S, Suite 205, Okatie, SC 29909-7507 | 2006-01-05 |
| 1902808827 | Robert D Black | Internal Medicine | 3600 Gaston Avenue, Suite 806, Dallas, TX 75246-1808 | 2005-08-11 |
| 1003373713 | Robert William Black | Counselor | 995 Gateway Center Way Ste 300, San Diego, CA 92102-4550 | 2019-02-28 |
| 1861985657 | Robert Lee Black IIi | Physician Assistant | 640 Alden St, Meadville, PA 16335-2348 | 2018-06-07 |
| Street Address |
1400 W PARK ST |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801862461 | Shamim Sadiq | Internal Medicine | 1400 W Park St, Urbana, IL 61801-2334 | 2006-02-24 |
| 1548873938 | Audra Leigh Cisna | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801-2334 | 2020-08-26 |
| 1689200750 | Holly Tompkins | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801-2334 | 2020-03-20 |
| 1417419045 | Latifa Omran | Technician/Technologist | 1400 W Park St, Urbana, IL 61801-2334 | 2019-04-02 |
| 1588134084 | Lauren Dowd | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801 | 2018-11-28 |
| 1053801514 | Sarah Kristine Farison | Speech-Language Pathologist | 1400 W Park St, Urbana, IL 61801-2334 | 2018-05-10 |
| 1316437882 | Tian Lan | Physical Therapist | 1400 W Park St, Urbana, IL 61801-2334 | 2018-05-10 |
| 1659884476 | Osf Healthcare System | General Acute Care Hospital | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
| 1093228835 | Osf Healthcare System | Ambulance | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
| 1649783473 | Osf Healthcare System | General Acute Care Hospital | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669438198 | Napoleon B Knight | Emergency Medicine | 611 W Park Street, Emergency Medicine, Urbana, IL 61801 | 2006-04-24 |
| 1811966781 | William (brad) B Weir | Emergency Medicine | 611 W. Park Street, Emergency Medicine, Urbana, IL 61801 | 2006-03-14 |
| 1407858871 | Spfld Urb Emergency Physicians Inc | Emergency Medicine | 904 Scioto St, Urbana, OH 43078-2226 | 2005-08-15 |
| 1083144232 | Brendan Mcevoy | Emergency Medicine | 611 W Park St, Urbana, IL 61801-2512 | 2017-06-19 |
| 1790135499 | Zakaria Abdulnabi | Emergency Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2016-06-14 |
| 1104292150 | Lars Grant | Emergency Medicine | 1400 W Park St, Emergency Department, Urbana, IL 61801-2334 | 2015-08-13 |
| 1366857906 | Eric S Toone | Emergency Medicine | 611 W. Park St., Emergency Med., Urbana, IL 61801-2500 | 2014-06-23 |
| 1053750935 | Imran Khan | Emergency Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2013-06-24 |
| 1710326350 | Kurt Bloomstrand | Emergency Medicine | 1400 W Park St, Presence Covenant Medical Center, Urbana, IL 61801-2334 | 2013-06-17 |
| 1477997369 | Clinton R Holaday | Emergency Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2013-04-22 |
| Find all providers in URBANA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.