1669600375 NPI number — DR. SAMANTHA STARRETT ROBINSON M.D.

Table of content: DR. SAMANTHA STARRETT ROBINSON M.D. (NPI 1669600375)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669600375 NPI number — DR. SAMANTHA STARRETT ROBINSON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
SAMANTHA
Provider Middle Name:
STARRETT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STARRETT
Provider Other First Name:
SAMANTHA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669600375
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2550 COMPASS RD
Provider Second Line Business Mailing Address:
SUITE AB
Provider Business Mailing Address City Name:
GLENVIEW
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60026-1610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-904-7800
Provider Business Mailing Address Fax Number:
847-904-7122

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2550 COMPASS RD
Provider Second Line Business Practice Location Address:
SUITE AB
Provider Business Practice Location Address City Name:
GLENVIEW
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60026-1610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-904-7800
Provider Business Practice Location Address Fax Number:
847-904-7122
Provider Enumeration Date:
07/01/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  036129330 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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