MEDICARE: CARLA ROBINSON

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1518527761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA ROBINSON

Provider Business Mailing Address
First Line	:	7373 N LINCOLN AVE
Second Line	:
City	:	LINCOLNWOOD
State	:	IL
Zip	:	60712-1715
Country	:	US
Telephone Number	:	812-573-7707
Fax Number	:

Provider Business Practice Location Address
First Line	:	7373 N LINCOLN AVE
Second Line	:
City	:	LINCOLNWOOD
State	:	IL
Zip	:	60712-1715
Country	:	US
Telephone Number	:	774-341-5310
Fax Number	:

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

Provider Enumeration Date	:	06/19/2019
Last Update Date	:	05/04/2026

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