Provider Demographics
NPI:1528521283
Name:BLONDIN, ROBIN ANN (MS SPEECH PATHOLOGY)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANN
Last Name:BLONDIN
Suffix:
Gender:F
Credentials:MS SPEECH PATHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60554-9248
Mailing Address - Country:US
Mailing Address - Phone:630-715-9189
Mailing Address - Fax:
Practice Address - Street 1:FEARN ELEMENTARY SCHOOL
Practice Address - Street 2:1600 HAWKSLEY LANE
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542
Practice Address - Country:US
Practice Address - Phone:630-301-5124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146000650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist