Healthcare Provider Details

I. General information

NPI: 1447244918
Provider Name (Legal Business Name): ROBIN J ROBINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S GARY AVE ST. 200
BLOOMINGDALE IL
60108-2228
US

IV. Provider business mailing address

245 S GARY AVE ST. 200
BLOOMINGDALE IL
60108-2228
US

V. Phone/Fax

Practice location:
  • Phone: 630-894-8404
  • Fax: 630-894-8026
Mailing address:
  • Phone: 630-894-8404
  • Fax: 630-894-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number036083146
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: