Provider Demographics
NPI:1730417056
Name:ROBBINS, TERESA ANN (MS)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:ANN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 BARNABY DR
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8678
Mailing Address - Country:US
Mailing Address - Phone:630-803-2295
Mailing Address - Fax:
Practice Address - Street 1:120 OSLER LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7429
Practice Address - Country:US
Practice Address - Phone:630-527-5354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009941235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL363297173001Medicaid
140231Medicare PIN