Provider Demographics
NPI:1700619848
Name:ROBINSON, TAUHEEDAH L (CERTIFIED OPTICIAN)
Entity type:Individual
Prefix:
First Name:TAUHEEDAH
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CERTIFIED OPTICIAN
Other - Prefix:
Other - First Name:TAUHEEDAH
Other - Middle Name:L
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CERTIFIED OPTICIAN
Mailing Address - Street 1:34121 N.RT. 45
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030
Mailing Address - Country:US
Mailing Address - Phone:224-541-4077
Mailing Address - Fax:
Practice Address - Street 1:34121 N. U.S. RT 45
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030
Practice Address - Country:US
Practice Address - Phone:224-541-4077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear SupplierGroup - Single Specialty