Provider Demographics
NPI:1366484313
Name:ROBIN, ERWIN LEE (MD)
Entity Type:Individual
Prefix:
First Name:ERWIN
Middle Name:LEE
Last Name:ROBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE.
Mailing Address - Street 2:KELLOGG CANCER CENTER
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-2112
Mailing Address - Fax:847-570-1041
Practice Address - Street 1:2650 RIDGE AVE.
Practice Address - Street 2:KELLOGG CANCER CENTER
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:847-570-2112
Practice Address - Fax:847-570-1041
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036054928207RX0202X
IN01038072A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100016520FMedicaid
IN100394430Medicaid
IL036054928Medicaid
IN100394430Medicaid
C37819Medicare UPIN
IL036054928Medicaid
ILL60693Medicare PIN
IN100016520FMedicaid
IN626820AMedicare PIN
IL437901Medicare ID - Type UnspecifiedMCARE GROUP PROV #