Active NPI
Roxanne R Roberts, MD
- Trauma Surgery Physician
- Chicago, IL
National Provider Identifier
1497873970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- Practice address
- 1900 W Polk St
Trauma Office 1300
Chicago, IL 60612-3723 - Phone
- (312) 864-2754
- Fax
- (312) 864-9169
- NPI assigned
- Mar 26, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Trauma Surgery Physician | 2086S0127X | IL | Primary |
Addresses
Primary practice location
1900 W Polk St
Trauma Office 1300
Chicago, IL 60612-3723
Mailing address
5985 Trail End Rd
Three Oaks, MI 49128-9760
Phone (269) 756-7477
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-064240 | IL | MD | Trauma Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497873970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5985 TRAIL END RD",
"city": "THREE OAKS",
"state": "MI",
"postal_code": "491289760",
"telephone_number": "269-756-7477",
"fax_number": "312-864-9020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 W POLK ST",
"address_2": "TRAUMA OFFICE 1300",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123723",
"telephone_number": "312-864-2754",
"fax_number": "312-864-9169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "ROXANNE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jul 8, 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.