Gloria Jean Whitlock Robertson

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

057002512 Issued in IL

Practice address

21020 Kostner Ave
Matteson, IL 60443-2068

Phone

(708) 747-1300

NPI assigned

May 1, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Gloria Robertson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1053587915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 139TH PL",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604063345",
            "telephone_number": "708-489-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21020 KOSTNER AVE",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432068",
            "telephone_number": "708-747-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK ROBERTSON",
        "first_name": "GLORIA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "057002512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "ROBERTSON",
            "credential": "CERTIFIED",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Occupational Therapist in Matteson, IL
• Providers in Matteson, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.