Individual provider Active NPI

Pamela A Robertson, CNM

  • Advanced Practice Midwife
  • Chicago, IL
National Provider Identifier
1558417501
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209001335 Issued in IL
Practice address
326 W 64TH St
Chicago, IL 60621-3114
Phone
(773) 962-4075
Fax
(773) 602-3857
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209001335 IL Primary

Addresses

Primary practice location

326 W 64TH St
Chicago, IL 60621-3114

Mailing address

326 W 64TH St
Suite 214
Chicago, IL 60621-3114
Phone (773) 962-4075

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
Certified Nurse Midwife

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1558417501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "address_2": "SUITE 214",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-4075",
            "fax_number": "773-602-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "PAMELA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209001335",
            "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 Nov 16, 2016; 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.