Individual provider Active NPI

Monique Roebuck, LMT

  • Massage Therapist
  • Aurora, IL
National Provider Identifier
1679132831
Registry record updated Jun 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227009615 Issued in IL
Practice address
2411 Georgetown Cir
Aurora, IL 60503-6714
Phone
(815) 375-0163
NPI assigned
Jun 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 227009615 IL Primary

Addresses

Primary practice location

2411 Georgetown Cir
Aurora, IL 60503-6714

Mailing address

2704 Village Green Dr Apt B2
Aurora, IL 60504-7249
Phone (815) 375-0163

Other practice location 1

15475 S Park Ave Ste 108B
South Holland, IL 60473-1377
Phone (815) 375-0163

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
227009615ILMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gifted Hands Massage and Bodywork LLC Massage Therapist CurrentSince Sep 10, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591401600000",
    "number": "1679132831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 VILLAGE GREEN DR APT B2",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047249",
            "telephone_number": "815-375-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 GEORGETOWN CIR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605036714",
            "telephone_number": "815-375-0163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15475 S Park Ave Ste 108B",
            "address_purpose": "LOCATION",
            "city": "South Holland",
            "state": "IL",
            "postal_code": "604731377",
            "country_code": "US",
            "telephone_number": "815-375-0163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROEBUCK",
        "first_name": "MONIQUE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2020-06-06",
        "certification_date": "2020-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227009615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2020; 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.