Healthcare Provider Details

I. General information

NPI: 1669904124
Provider Name (Legal Business Name): RALPH N. ROBBINS D.D.S., LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 GOLF MILL PROF. BLDG. SUITE 905
NILES IL
60714
US

IV. Provider business mailing address

241 GOLF MILL PROF BLDG SUITE #905
NILES IL
60714
US

V. Phone/Fax

Practice location:
  • Phone: 847-298-6030
  • Fax: 847-298-6032
Mailing address:
  • Phone: 847-298-6030
  • Fax: 847-298-6032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number215944
License Number StateIL

VIII. Authorized Official

Name: DR. RALPH N. ROBBINS
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 847-298-6030