Provider Demographics
NPI:1659345759
Name:MITCHELL, ROBBIN L (DC)
Entity Type:Individual
Prefix:
First Name:ROBBIN
Middle Name:L
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E LOOP RD
Mailing Address - Street 2:SUITE #203
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-2038
Mailing Address - Country:US
Mailing Address - Phone:630-665-8688
Mailing Address - Fax:630-665-4705
Practice Address - Street 1:55 E LOOP RD
Practice Address - Street 2:SUITE #203
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-2038
Practice Address - Country:US
Practice Address - Phone:630-665-8688
Practice Address - Fax:630-665-4705
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03801630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2282051OtherBCBS
IL204844Medicare ID - Type Unspecified