Provider Demographics
NPI:1003620865
Name:STEPHENS, ROBIN LYNN (LMT)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 E MAY ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-4002
Mailing Address - Country:US
Mailing Address - Phone:312-730-7879
Mailing Address - Fax:
Practice Address - Street 1:130 N LA GRANGE RD STE 107
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2005
Practice Address - Country:US
Practice Address - Phone:630-331-4431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227008042225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist