Active NPI
Erin Kathryn Roberts, D.O.
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1417202920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02004738A
- Practice address
- 2233 W Division St
Chicago, IL 60622-8151 - Phone
- (312) 770-2128
- NPI assigned
- Jul 20, 2012
- Last updated
- Mar 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125.062248 | IL | |
| Family Medicine Physician | 207Q00000X | 02004738A | IN | Primary |
Addresses
Primary practice location
2233 W Division St
Chicago, IL 60622-8151
Mailing address
8400 Louisiana St
Merrillville, IN 46410-6385
Phone (219) 757-1928
Other practice location 1
559 State St
Hammond, IN 46320-1533
Phone (219) 937-3300
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | eroberts21084@ce-direct.presencehealth.org |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.062248 | IL | MD | Family Medicine Physician |
| 02004738A | IN | MD | Family Medicine Physician |
Interoperability endpoints
- eroberts21084@ce-direct.presencehealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616716800000",
"number": "1417202920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8400 LOUISIANA ST",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464106385",
"telephone_number": "219-757-1928",
"fax_number": "219-757-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2233 W DIVISION ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606228151",
"telephone_number": "312-770-2128"
}
],
"practiceLocations": [
{
"address_1": "559 State St",
"address_purpose": "LOCATION",
"city": "Hammond",
"state": "IN",
"postal_code": "463201533",
"country_code": "US",
"telephone_number": "219-937-3300",
"fax_number": "219-803-7252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROBERTS",
"first_name": "ERIN",
"middle_name": "KATHRYN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-20",
"last_updated": "2021-03-26",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "125.062248",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "02004738A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "eroberts21084@ce-direct.presencehealth.org",
"affiliation": "N",
"address_1": "2233 W Division St",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606228151",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.