Provider Demographics
NPI:1174828248
Name:KIEFFER, ROBIN JEAN
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:JEAN
Last Name:KIEFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39266 N NORTH AVE.
Mailing Address - Street 2:
Mailing Address - City:BEACH PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60099-3780
Mailing Address - Country:US
Mailing Address - Phone:847-246-3789
Mailing Address - Fax:
Practice Address - Street 1:39266 N NORTH AVE
Practice Address - Street 2:
Practice Address - City:BEACH PARK
Practice Address - State:IL
Practice Address - Zip Code:60099-3780
Practice Address - Country:US
Practice Address - Phone:847-246-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist