MEDICARE: DR. BEVERLEY ROBIN MD

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	2080N0001X	Neonatal-Perinatal Medicine Physician	036100413	IL
2	2080N0001X	Neonatal-Perinatal Medicine Physician	01065473A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	000000647638	OTHER	IN	ANTHEM
4	000000632893	OTHER	IN	ANTHEM PROVIDER NUMBER
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487607891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEVERLEY ROBIN MD

Provider Business Mailing Address
First Line	:	1464 S MICHIGAN AVE
Second Line	:	SUITE 1304
City	:	CHICAGO
State	:	IL
Zip	:	60605-3711
Country	:	US
Telephone Number	:	773-320-5727
Fax Number	:	312-939-0188

Provider Business Practice Location Address
First Line	:	1464 S MICHIGAN AVE
Second Line	:	SUITE 1304
City	:	CHICAGO
State	:	IL
Zip	:	60605-3711
Country	:	US
Telephone Number	:	773-320-5727
Fax Number	:	312-939-0188

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	03/17/2010

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Directions to “ DR. BEVERLEY ROBIN MD” Practice Location

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