Provider Demographics
NPI: | 1831196476 |
---|---|
Name: | ROBIN, ARNOLD P (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | ARNOLD |
Middle Name: | P |
Last Name: | ROBIN |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1430 N ARLINGTON HEIGHTS RD |
Mailing Address - Street 2: | SUITE 105 |
Mailing Address - City: | ARLINGTON HEIGHTS |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60004-4830 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 847-259-8226 |
Mailing Address - Fax: | 847-392-5260 |
Practice Address - Street 1: | 1430 N ARLINGTON HEIGHTS RD |
Practice Address - Street 2: | SUITE 105 |
Practice Address - City: | ARLINGTON HEIGHTS |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60004-4830 |
Practice Address - Country: | US |
Practice Address - Phone: | 847-259-8226 |
Practice Address - Fax: | 847-392-5260 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-06-28 |
Last Update Date: | 2016-06-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IL | 036057176 | 207R00000X, 208600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IL | D13565 | Medicare UPIN | |
IL | 31601993 | Other | BC/BS OF IL PROVIDER# |