1588916472 NPI number — ROBIN PASTORE DPM PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588916472 NPI number — ROBIN PASTORE DPM PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBIN PASTORE DPM PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588916472
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9400 S CICERO AVE STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAK LAWN
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60453-2536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-424-3201
Provider Business Mailing Address Fax Number:
708-424-5001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1N141 COUNTY FARM RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
WINFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60190-2032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-510-0998
Provider Business Practice Location Address Fax Number:
630-510-0877
Provider Enumeration Date:
10/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
PASTORE
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
630-510-0998

Provider Taxonomy Codes

  • Taxonomy code: 332900000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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