Provider Demographics
NPI:1497323596
Name:ROBIN, MEGAN LYNN (DMD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:LYNN
Last Name:ROBIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CATTAIL CT
Mailing Address - Street 2:
Mailing Address - City:HAWTHORN WOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60047-8006
Mailing Address - Country:US
Mailing Address - Phone:847-331-1230
Mailing Address - Fax:
Practice Address - Street 1:4 CATTAIL CT
Practice Address - Street 2:
Practice Address - City:HAWTHORN WOODS
Practice Address - State:IL
Practice Address - Zip Code:60047-8006
Practice Address - Country:US
Practice Address - Phone:847-331-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0332061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019.033206OtherIDFPR