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General NPI Number Information
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NPI Number | 1104178268
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Entity Type | Organization
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Legal Business Name | ROBINSON SENIOR CARE INC
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 3151 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60616-3814
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Country | US
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Telephone | 312-326-1367
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Fax | 312-326-1364
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Provider Business Mailing Address
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Address Line | 3151 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60616-3814
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Country | US
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Telephone | 312-326-1367
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Fax | 312-326-1364
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAM ROBINSON III
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Credential | PHD, CSA
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Telephone | 312-326-1367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 3000355
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License Number State | IL
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