Provider Demographics
NPI:1114953791
Name:PASTORE, ROBIN L (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:L
Last Name:PASTORE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1N141 COUNTY FARM RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-2032
Mailing Address - Country:US
Mailing Address - Phone:630-510-0098
Mailing Address - Fax:630-510-0877
Practice Address - Street 1:1N141 COUNTY FARM RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-2032
Practice Address - Country:US
Practice Address - Phone:630-510-0098
Practice Address - Fax:630-510-0877
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1114953791Medicaid
ILU71472Medicare UPIN