Healthcare Provider Details

I. General information

NPI: 1770902041
Provider Name (Legal Business Name): ROBERT WILLIAM TERMANINI MD,BA,BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RAMI TERMANINI MD,BA,BS

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 N BURLING ST
CHICAGO IL
60610-5265
US

IV. Provider business mailing address

1336 N BURLING ST
CHICAGO IL
60610-5265
US

V. Phone/Fax

Practice location:
  • Phone: 212-777-3960
  • Fax:
Mailing address:
  • Phone: 973-570-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number1
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: