ROBERT C. WANLESS M.D. NPI 1548258288

NPI Information

  • NPI: 1548258288
  • Provider Name: ROBERT C. WANLESS, M.D.
  • Classification: Plastic Surgery - 208200000X
  • Entity Type: Individual
  • Address: 4600 MEMORIAL DR
    SUITE 320
    BELLEVILLE, IL
    ZIP 62226
  • Phone: (618) 257-2100

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NPI Details

Robert C. Wanless, M.D. is a plastic surgery in Belleville, IL. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. Robert C. Wanless, M.D. NPI is 1548258288. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4600 MEMORIAL DR
SUITE 320
BELLEVILLE, IL
ZIP 62226-366
Phone: (618) 257-2100
Fax: (618) 257-2169

The enumeration date for this NPI number is 10/6/2005 and was last updated on 3/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic Surgery036 - 052657ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1A - 12878MEDICARE UPIN
2IL3521024MEDICARE PINILLINOIS
3K - 16890MEDICARE ID-TYPE UNSPECIFIEDINDIVIDUAL MEDICARE #
4036052657MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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