MEDICARE: DR. ROBIN R GAY DDS

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	122300000X	Dentist		IL

General Provider Information

NPI Number	:	1548461940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN R GAY DDS

Provider Business Mailing Address
First Line	:	5413 COMMONWEALTH
Second Line	:
City	:	WESTERN SPRINGS
State	:	IL
Zip	:	60558
Country	:	US
Telephone Number	:	312-298-1176
Fax Number	:	312-274-3334

Provider Business Practice Location Address
First Line	:	676 N MICHIGAN AVE
Second Line	:	35 TH FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60611-2883
Country	:	US
Telephone Number	:	312-981-1176
Fax Number	:	312-274-3334

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

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	07/08/2007

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