Provider Demographics
NPI:1013453463
Name:PHILIPPS, ROBERT (BSPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:PHILIPPS
Suffix:
Gender:M
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2105
Mailing Address - Country:US
Mailing Address - Phone:708-599-5000
Mailing Address - Fax:708-599-0801
Practice Address - Street 1:6701 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2105
Practice Address - Country:US
Practice Address - Phone:708-599-5000
Practice Address - Fax:708-599-0801
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.006275225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist