Provider Demographics
NPI:1750584058
Name:ROBINSON, ELISHA JAMYCE (MD)
Entity type:Individual
Prefix:DR
First Name:ELISHA
Middle Name:JAMYCE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2509 MANDRAKE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-8132
Mailing Address - Country:US
Mailing Address - Phone:815-986-8205
Mailing Address - Fax:815-676-6256
Practice Address - Street 1:2509 MANDRAKE DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-8132
Practice Address - Country:US
Practice Address - Phone:815-986-8205
Practice Address - Fax:815-676-6256
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2016-12-22
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Provider Licenses
StateLicense IDTaxonomies
IL036130252208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery