Healthcare Provider Details

I. General information

NPI: 1457771792
Provider Name (Legal Business Name): CANARY TELEHEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2014
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3151 S MICHIGAN AVE
CHICAGO IL
60616-3814
US

IV. Provider business mailing address

3151 S MICHIGAN AVE
CHICAGO IL
60616-3814
US

V. Phone/Fax

Practice location:
  • Phone: 312-780-0812
  • Fax: 312-326-1364
Mailing address:
  • Phone: 312-780-0812
  • Fax: 312-326-1364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SAM ROBINSON III
Title or Position: PRESIDENT
Credential: PHD
Phone: 312-780-0812