Healthcare Provider Details

I. General information

NPI: 1598643983
Provider Name (Legal Business Name): DESTINY ROBINSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

1529 S STATE ST APT 15-B
CHICAGO IL
60605-3104
US

V. Phone/Fax

Practice location:
  • Phone: 886-600-2273
  • Fax:
Mailing address:
  • Phone: 847-997-3668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number041540840
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number041540840
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: