Provider Demographics
NPI:1447244918
Name:ROBINSON, ROBIN J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:J
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:245 S GARY AVE
Mailing Address - Street 2:ST. 200
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2228
Mailing Address - Country:US
Mailing Address - Phone:630-894-8404
Mailing Address - Fax:630-894-8026
Practice Address - Street 1:245 S GARY AVE
Practice Address - Street 2:ST. 200
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2228
Practice Address - Country:US
Practice Address - Phone:630-894-8404
Practice Address - Fax:630-894-8026
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360831462083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036083146Medicaid
BR3688427OtherDEA
BR3688427OtherDEA