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NPI Code Detail

MEDICARE: MR. MICHAEL ANTHONY ROBINSON R. PH.

MEDICARE:  MR. MICHAEL ANTHONY ROBINSON  R. PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist051035455IL

General Provider Information

NPI Number : 1104103704
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MICHAEL ANTHONY ROBINSON R. PH.
Provider Business Mailing Address
First Line : 1213 W 79TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60620-3706
Country : US
Telephone Number : 773-651-2118
Fax Number :
Provider Business Practice Location Address
First Line : 1213 W 79TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60620-3706
Country : US
Telephone Number : 773-651-2118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2011
Last Update Date : 11/09/2011

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Directions to “ MR. MICHAEL ANTHONY ROBINSON R. PH.” Practice Location

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