Provider Demographics
NPI:1841450681
Name:NELSON, DELPHINE ROBOTHAM (MD)
Entity type:Individual
Prefix:DR
First Name:DELPHINE
Middle Name:ROBOTHAM
Last Name:NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DELPHINE
Other - Middle Name:
Other - Last Name:ROBOTHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1439 S MICHIGAN AVE
Mailing Address - Street 2:UNIT103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2867
Mailing Address - Country:US
Mailing Address - Phone:410-935-6423
Mailing Address - Fax:312-227-9405
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:MS #37
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1407702080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology