Healthcare Provider Details

I. General information

NPI: 1144809633
Provider Name (Legal Business Name): DANTE ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2021
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 W STEPHENSON ST
FREEPORT IL
61032-4864
US

IV. Provider business mailing address

1045 W STEPHENSON ST
BROOKLYN IL
11203-2012
US

V. Phone/Fax

Practice location:
  • Phone: 815-599-6000
  • Fax: 815-599-7974
Mailing address:
  • Phone: 815-599-6000
  • Fax: 815-599-7974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036.179216
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: