Provider Demographics
NPI:1184682072
Name:BIBBY, ROBERT CHRISTOPHER (PSYD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:BIBBY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 W ALDER DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1509
Mailing Address - Country:US
Mailing Address - Phone:224-238-0991
Mailing Address - Fax:888-975-0235
Practice Address - Street 1:830 E HIGGINS RD
Practice Address - Street 2:SUITE 111C
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4797
Practice Address - Country:US
Practice Address - Phone:224-238-0991
Practice Address - Fax:888-975-0235
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.007468103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN608960IIMedicare ID - Type Unspecified