Healthcare Provider Details

I. General information

NPI: 1003723685
Provider Name (Legal Business Name): ROBYN R HARWELL DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 W 177TH ST
HAZEL CREST IL
60429-2002
US

IV. Provider business mailing address

529 LAKEWOOD BLVD
PARK FOREST IL
60466-1533
US

V. Phone/Fax

Practice location:
  • Phone: 708-225-3636
  • Fax: 708-799-8363
Mailing address:
  • Phone: 708-225-3636
  • Fax: 708-799-8363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number041208969
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: