Provider Demographics
NPI:1508333592
Name:ROBINSON, JOHN BOYCE JR
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BOYCE
Last Name:ROBINSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W BODE CIR APT 117
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2920
Mailing Address - Country:US
Mailing Address - Phone:847-312-0558
Mailing Address - Fax:
Practice Address - Street 1:4225 KIRCHOFF RD
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-2005
Practice Address - Country:US
Practice Address - Phone:847-397-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-28
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.003573224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty