Individual provider Active NPI

Tammara Elise Roberson-Green, PT

  • Physical Therapist
  • Calumet City, IL
National Provider Identifier
1912141847
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070.005013 Issued in IL
Practice address
1370 Ring Rd
Calumet City, IL 60409-5428
Phone
(708) 217-2667
NPI assigned
Apr 22, 2009
Last updated
Apr 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070.005013 IL Primary

Addresses

Primary practice location

1370 Ring Rd
Calumet City, IL 60409-5428

Mailing address

17840 Cedar Ave
Country Club Hills, IL 60478-4733
Phone (708) 217-2667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250403000941 IL Practitioner - Physical Therapist in Private Practice 0547783235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

1015 Oconor Ave
La Salle, IL 61301-1216
Phone (224) 616-5446

1370 Ring Rd
Calumet City, IL 60409-5428
Phone (708) 622-0108

2800 Desplaines Ave
North Riverside, IL 60546-1851
Phone (708) 443-4217

3025 Spring Lake Dr
Lansing, IL 60438-4403
Phone (708) 412-4003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.005013ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Mar 1, 2025 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Mar 1, 2025 Accepting new patients

Locations

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

536 Old Howell Rd
Greenville, SC 29615
Phone (864) 527-5970

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1912141847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17840 CEDAR AVE",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604784733",
            "telephone_number": "708-217-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 RING RD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095428",
            "telephone_number": "708-217-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON-GREEN",
        "first_name": "TAMMARA",
        "middle_name": "ELISE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-22",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.005013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calumet City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.