Healthcare Provider Details

I. General information

NPI: 1770503732
Provider Name (Legal Business Name): ROBIN WIND MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 02/14/2020
Certification Date: 02/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 WINNETKA AVE
WINNETKA IL
60093-4050
US

IV. Provider business mailing address

525 WINNETKA AVE STE 3
WINNETKA IL
60093-4050
US

V. Phone/Fax

Practice location:
  • Phone: 847-446-1112
  • Fax: 847-446-1717
Mailing address:
  • Phone: 847-446-1112
  • Fax: 847-446-1717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036089426
License Number StateIL

VIII. Authorized Official

Name: ROBIN M WIND
Title or Position: OWNER
Credential: MD
Phone: 847-446-1112