Provider Demographics
NPI:1336114560
Name:ROBIN FINTEL M.D.S.C.
Entity Type:Organization
Organization Name:ROBIN FINTEL M.D.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:FINTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-926-1600
Mailing Address - Street 1:P.O. BOX 1418
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1418
Mailing Address - Country:US
Mailing Address - Phone:847-430-6450
Mailing Address - Fax:866-869-5175
Practice Address - Street 1:737 N. MICHIGAN AVE SUITE 960
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-6659
Practice Address - Country:US
Practice Address - Phone:312-926-1600
Practice Address - Fax:312-926-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036070925Medicaid
IL3160225579OtherBLUE CROSS / BLUE SHIELD
IL3160225579OtherBLUE CROSS / BLUE SHIELD