MEDICARE: DRS. DUDLEY, ROBINSON, JAMES, LTD.

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	1223G0001X	General Practice Dentistry	019-13341	IL

General Provider Information

NPI Number	:	1639342272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS. DUDLEY, ROBINSON, JAMES, LTD.

Provider Business Mailing Address
First Line	:	1500 E 87TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60619-6525
Country	:	US
Telephone Number	:	773-721-1333
Fax Number	:	773-721-1730

Provider Business Practice Location Address
First Line	:	1500 E 87TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60619-6525
Country	:	US
Telephone Number	:	773-721-1333
Fax Number	:	773-721-1730

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. MARK ANTHONY ROBINSON
Credential	:	DDS
Telephone Number	:	773-721-1333

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	04/17/2008

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