Provider Demographics
NPI:1447499470
Name:ROBIN, MATTHEW S (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:S
Last Name:ROBIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W DIVERSEY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1412
Mailing Address - Country:US
Mailing Address - Phone:312-796-7121
Mailing Address - Fax:888-523-4767
Practice Address - Street 1:800 W DIVERSEY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1412
Practice Address - Country:US
Practice Address - Phone:312-796-7121
Practice Address - Fax:888-523-4767
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-14
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250551972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry