Provider Demographics
NPI:1003004789
Name:POSTON, ROBIN (OT)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:POSTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 E EMPIRE ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-3738
Mailing Address - Country:US
Mailing Address - Phone:309-454-1616
Mailing Address - Fax:309-454-5167
Practice Address - Street 1:2200 FORT JESSE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-6286
Practice Address - Country:US
Practice Address - Phone:309-454-1616
Practice Address - Fax:309-454-5167
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-003678225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist