MEDICARE: KATHRYN ROBB

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
1	1041C0700X	Clinical Social Worker		IL
2	104100000X	Social Worker	6801096390	MI

General Provider Information

NPI Number	:	1114337433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN ROBB

Provider Business Mailing Address
First Line	:	231 W ROCKLAND RD
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-2711
Country	:	US
Telephone Number	:	248-303-0130
Fax Number	:

Provider Business Practice Location Address
First Line	:	231 W ROCKLAND RD
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-2711
Country	:	US
Telephone Number	:	248-303-0130
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	05/06/2026

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