Provider Demographics
NPI:1275641003
Name:WHATLEY, ROBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:WHATLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:WHATLEY-BEACHUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10350 HALIGUS RD STE 120
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9526
Mailing Address - Country:US
Mailing Address - Phone:815-356-2323
Mailing Address - Fax:847-802-7201
Practice Address - Street 1:215 REMINGTON BLVD
Practice Address - Street 2:G
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-3656
Practice Address - Country:US
Practice Address - Phone:630-312-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093548207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL399980OtherMEDICARE GROUP PTAN
IL036093548Medicaid
ILK39862Medicare PIN