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General NPI Number Information
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NPI Number | 1457771792
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Entity Type | Organization
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Legal Business Name | CANARY TELEHEALTH INC
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 09/12/2025
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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 | 312-780-0812
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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 | 312-780-0812
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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
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Telephone | 312-780-0812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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