Provider Demographics
NPI:1962414128
Name:ROBINSON, RICHARD TODD (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:TODD
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DC
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 369
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-0369
Mailing Address - Country:US
Mailing Address - Phone:847-963-4894
Mailing Address - Fax:847-770-4401
Practice Address - Street 1:2168 PLUM GROVE RD
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-1932
Practice Address - Country:US
Practice Address - Phone:847-963-4894
Practice Address - Fax:847-359-4199
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL534510Medicare ID - Type Unspecified
ILU74009Medicare UPIN