Nichole Metice Roberts, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-124248 Issued in IL

Practice address

7531 S Stony Island Ave
Suite164
Chicago, IL 60649-3954

Phone

(773) 947-2831

NPI assigned

Nov 19, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nichole.roberts@lvmc.eclinicaldirectplus.com

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.

• Centegra Primary Care, LLC

  dba Centegra Physician Care, LLC

  • Family Medicine Physician
  • Woodstock, IL
  • NPI 1700905205

  Internal Medicine

  NPD (past)
• MD @ Home Illinois, SC

  dba Housecall Physicians of Illinois, SC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1568758415
  NPD (past)
• Rajiv Kandala M D S C

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1114094281
  NPD (past)
• Southside Primary Care Group SC

  dba Metro Medical Associates

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1417403072
  NPD (past)

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1215118229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "address_2": "SUITE 164",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7531 S STONY ISLAND AVE",
            "address_2": "SUITE164",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493954",
            "telephone_number": "773-947-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "NICHOLE",
        "middle_name": "METICE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-124248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "962341",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle E Roberts, DPT
• Monte J. Roberts, L.C.S.W.
• Morgan Roberts
• Nadia Shadea Roberts
• Nehezi Roberts
• Patrick Roberts, MS, ATC
• Rebecca J Roberts, LCPC
• Rene Roberts, M.D.
• Roxanne R Roberts, MD
• Samantha Roberts

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.