MEDICARE: DR. ROBERT WILLIAM TERMANINI MD,BA,BS

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	1744R1102X	Research Study Specialist
2	2084N0400X	Neurology Physician	0	IL
3	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	1	IL

General Provider Information

NPI Number	:	1770902041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT WILLIAM TERMANINI MD,BA,BS

Provider Business Mailing Address
First Line	:	1336 N BURLING ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-5265
Country	:	US
Telephone Number	:	973-570-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1336 N BURLING ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60610-5265
Country	:	US
Telephone Number	:	212-777-3960
Fax Number	:

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	03/01/2023

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