Individual
AMANDA ROBINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 W HACK ST, CULLOM, IL 60929-7133
(815) 689-2126
(815) 689-2131
Mailing address
105 W HACK ST, CULLOM, IL 60929-7133
(815) 689-2126
(815) 689-2131
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085006059
IL
363AM0700X
Medical Physician Assistant
Primary
085006059
IL
Other
Enumeration date
11/14/2016
Last updated
07/23/2019
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