Active NPI
Joshua M Roberts, ATC
- Athletic Trainer
- Elmhurst, IL
National Provider Identifier
1013103928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 096.0022417
- Practice address
- 533 S York Rd Ste D
Elmhurst, IL 60126-4467 - Phone
- (630) 833-4437
- Fax
- (630) 833-4438
- NPI assigned
- Sep 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096.0022417 | IL | Primary |
Addresses
Primary practice location
533 S York Rd Ste D
Elmhurst, IL 60126-4467
Mailing address
100-4 Driscoll Lane
Wood Dale, IL 60191
Phone (815) 593-0421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096.0022417 | IL | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elmhurst Olympic Service Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Elmhurst, IL
- NPI 1174696959
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1013103928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100-4 DRISCOLL LANE",
"city": "WOOD DALE",
"state": "IL",
"postal_code": "60191",
"telephone_number": "815-593-0421",
"fax_number": "630-833-4438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "533 S YORK RD STE D",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601264467",
"telephone_number": "630-833-4437",
"fax_number": "630-833-4438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "JOSHUA",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-25",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096.0022417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.