Provider Demographics
NPI:1619950680
Name:ROBINSON, KEITH (MD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:4205 WESTBROOK DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4124
Practice Address - Country:US
Practice Address - Phone:630-527-1818
Practice Address - Fax:630-527-1244
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13411208M00000X, 207R00000X
IL036-176424207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH020470410OtherTAX ID
NH30206121Medicaid
NH3073094Medicaid
NH01Y010886NH01OtherBCBS
MA2105161Medicaid
NH01Y010886NH01OtherBCBS
NHI31864Medicare UPIN
I31864Medicare UPIN
NH000035502Medicare PIN