MEDICARE: DORE ELIZABETH ROBINSON D.O.

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	207QS0010X	Sports Medicine (Family Medicine) Physician	20A 11728	CA
2	207QS0010X	Sports Medicine (Family Medicine) Physician	036126177	IL

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

General Provider Information

NPI Number	:	1548415367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORE ELIZABETH ROBINSON D.O.

Provider Business Mailing Address
First Line	:	PO BOX 713260
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-1260
Country	:	US
Telephone Number	:	630-469-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	9233 159TH ST
Second Line	:
City	:	ORLAND HILLS
State	:	IL
Zip	:	60487-5977
Country	:	US
Telephone Number	:	708-226-7000
Fax Number	:

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

Provider Enumeration Date	:	11/20/2008
Last Update Date	:	08/18/2023

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