Healthcare Provider Details

I. General information

NPI: 1699701607
Provider Name (Legal Business Name): ROBIN LOUISE COLBERT MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3816 S COTTAGE GROVE AVE UNIT 201
CHICAGO IL
60653-2009
US

IV. Provider business mailing address

3816 S. COTTAGE GROOVE AVE UNIT 201
CHICAGO IL
60653-1225
US

V. Phone/Fax

Practice location:
  • Phone: 773-403-1886
  • Fax:
Mailing address:
  • Phone: 773-403-1886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: