Provider Demographics
NPI:1801854856
Name:ROTHBARD, ROBIN B (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:B
Last Name:ROTHBARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1730 PARK ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2688
Mailing Address - Country:US
Mailing Address - Phone:630-718-0200
Mailing Address - Fax:630-718-0900
Practice Address - Street 1:3041 BUTTERFIELD RD # E100
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1146
Practice Address - Country:US
Practice Address - Phone:312-219-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083710207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036083710Medicaid
IL036083710Medicaid