Healthcare Provider Details

I. General information

NPI: 1356384390
Provider Name (Legal Business Name): JANET ROBINSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOOKS JANET MD

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S WALL ST
CARBONDALE IL
62901-3021
US

IV. Provider business mailing address

PO BOX 577
CARTERVILLE IL
62918-0577
US

V. Phone/Fax

Practice location:
  • Phone: 618-529-2621
  • Fax: 618-549-1288
Mailing address:
  • Phone: 618-956-9510
  • Fax: 618-985-6860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number036061125
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: