Provider Demographics
NPI:1932732237
Name:WILLIAMS, ROBINA RENEE
Entity Type:Individual
Prefix:
First Name:ROBINA
Middle Name:RENEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5833 COREY LN
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-3129
Mailing Address - Country:US
Mailing Address - Phone:708-446-3221
Mailing Address - Fax:
Practice Address - Street 1:16313 TURNER AVE
Practice Address - Street 2:
Practice Address - City:MARKHAM
Practice Address - State:IL
Practice Address - Zip Code:60428-5446
Practice Address - Country:US
Practice Address - Phone:708-446-3221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-15
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
177F00000X, 251S00000X, 253Z00000X, 282J00000X, 385H00000X
IL043.090690164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No177F00000XOther Service ProvidersLodging
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No385H00000XRespite Care FacilityRespite Care