Provider Demographics
NPI:1497843353
Name:CHIMIS, ROBERT S (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:CHIMIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HINES VA HOSPITAL
Mailing Address - Street 2:MENTAL HEALTH CLINIC (116A3)
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60141
Mailing Address - Country:US
Mailing Address - Phone:708-202-4658
Mailing Address - Fax:708-202-2108
Practice Address - Street 1:HINES VA HOSPITAL
Practice Address - Street 2:MENTAL HEALTH CLINIC (116A3)
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-4658
Practice Address - Fax:708-202-2108
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical