Provider Demographics
NPI:1568917300
Name:CEPEK, ROBYN (LAC)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:CEPEK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 DRAKE ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-2546
Mailing Address - Country:US
Mailing Address - Phone:262-210-0634
Mailing Address - Fax:
Practice Address - Street 1:1117 S MILWAUKEE AVE STE B6
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5259
Practice Address - Country:US
Practice Address - Phone:773-217-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001332171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist