Healthcare Provider Details

I. General information

NPI: 1013643386
Provider Name (Legal Business Name): MRS. ANNA LYNN ROBBINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 RIDGE AVE FL 2
EVANSTON IL
60202-3328
US

IV. Provider business mailing address

2114 W ROSCOE ST APT 2F
CHICAGO IL
60618-6220
US

V. Phone/Fax

Practice location:
  • Phone: 847-316-6262
  • Fax:
Mailing address:
  • Phone: 239-910-3005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: