Provider Demographics
NPI:1760744148
Name:ROBITAILLE, AILEEN ANNE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:AILEEN
Middle Name:ANNE
Last Name:ROBITAILLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 N ELM ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3625
Mailing Address - Country:US
Mailing Address - Phone:630-884-5913
Mailing Address - Fax:630-455-1759
Practice Address - Street 1:908 N ELM ST STE 300
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3625
Practice Address - Country:US
Practice Address - Phone:630-884-5913
Practice Address - Fax:630-455-1759
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.009589363LF0000X
IL209009589363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily