Provider Demographics
NPI:1700933967
Name:ROBINSON CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:ROBINSON CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:BSC, BS, DC
Authorized Official - Phone:815-730-3661
Mailing Address - Street 1:1226 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-4024
Mailing Address - Country:US
Mailing Address - Phone:815-730-3661
Mailing Address - Fax:815-730-3678
Practice Address - Street 1:1226 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-4024
Practice Address - Country:US
Practice Address - Phone:815-730-3661
Practice Address - Fax:815-730-3678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09927217OtherBLUE CROSS BLUE SHIELD ID
ILU82949Medicare UPIN
IL213355Medicare ID - Type Unspecified