Provider Demographics
NPI:1043519770
Name:POLSKY, ROBERT N (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:POLSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4436 S SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-7305
Mailing Address - Country:US
Mailing Address - Phone:847-790-6644
Mailing Address - Fax:
Practice Address - Street 1:4436 S SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-7305
Practice Address - Country:US
Practice Address - Phone:847-790-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036040487102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst