Provider Demographics
NPI:1538294202
Name:ROBSON, MARK ERIC (ATC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ERIC
Last Name:ROBSON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 DAWES ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3105
Mailing Address - Country:US
Mailing Address - Phone:847-367-9613
Mailing Address - Fax:
Practice Address - Street 1:603 DAWES ST
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3105
Practice Address - Country:US
Practice Address - Phone:847-367-9613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer