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General NPI Number Information
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NPI Number | 1104467760
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Entity Type | Individual
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Provider Name | MICHAEL ROBINSON ND, MS, CNS, LDN
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Gender | Male
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Dates
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Enumeration Date | 10/04/2019
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 5117B MAIN ST STE 3
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-4602
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Country | US
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Telephone | 630-432-0169
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Fax |
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Provider Business Mailing Address
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Address Line | 218 PLYMOUTH LN
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City | BOLINGBROOK
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State | IL
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Zip | 60440-1923
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Country | US
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Telephone | 708-699-3330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 099.0134102
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 164.007859
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License Number State | IL
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