Provider Demographics
NPI:1730209081
Name:ROBINSON, DIANE ELIZABETH (DC)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:ELIZABETH
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S WEBER RD STE 9A
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-5065
Mailing Address - Country:US
Mailing Address - Phone:815-293-3000
Mailing Address - Fax:815-372-9500
Practice Address - Street 1:600 S WEBER RD STE 9A
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-5065
Practice Address - Country:US
Practice Address - Phone:815-293-3000
Practice Address - Fax:815-372-9500
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-009177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL204373564OtherTAX ID
IL09921217OtherBCBS ID