Healthcare Provider Details

I. General information

NPI: 1699894238
Provider Name (Legal Business Name): ROBIN J SHAPIRO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 ELM PLACE SUITE 210
HIGHLAND PARK IL
60035
US

IV. Provider business mailing address

480 ELM PLACE SUITE 210
HIGHLAND PARK IL
60035
US

V. Phone/Fax

Practice location:
  • Phone: 312-520-9603
  • Fax: 312-268-5215
Mailing address:
  • Phone: 312-520-9603
  • Fax: 312-268-5215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036111730
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number03611730
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: