MEDICARE: DR. ROBIN GILSON PSYD

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	103TC0700X	Clinical Psychologist	071007926	IL

General Provider Information

NPI Number	:	1821360900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN GILSON PSYD

Provider Business Mailing Address
First Line	:	2740 W FOSTER AVE STE 310
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3547
Country	:	US
Telephone Number	:	773-878-8200
Fax Number	:	773-293-4197

Provider Business Practice Location Address
First Line	:	2740 W FOSTER AVE STE 412
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3532
Country	:	US
Telephone Number	:	773-878-8200
Fax Number	:	773-293-8804

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

Provider Enumeration Date	:	02/03/2012
Last Update Date	:	04/17/2018

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