Healthcare Provider Details

I. General information

NPI: 1770630212
Provider Name (Legal Business Name): LAWRENCE DAVID ROBBINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 LAKE COOK RD. SUITE 160
RIVERWOODS IL
60015
US

IV. Provider business mailing address

2610 LAKE COOK RD. SUITE 160
RIVERWOODS IL
60015
US

V. Phone/Fax

Practice location:
  • Phone: 847-374-9399
  • Fax: 847-374-9393
Mailing address:
  • Phone: 847-374-9399
  • Fax: 847-374-9393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0301X
TaxonomyBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
License Number33602998
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036-065660
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036065660
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: