Active NPI
Bruce Roberts, MD
- Psychiatry Physician
- Highland Park, IL
National Provider Identifier
1912974684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 36057770
- Practice address
- 275 Poplar Rd
Highland Park, IL 60035-4346 - Phone
- (312) 404-4261
- Fax
- (708) 202-2085
- NPI assigned
- Mar 2, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 36057770 | IL | Primary |
Addresses
Primary practice location
275 Poplar Rd
Highland Park, IL 60035-4346
Mailing address
275 Poplar Rd
Highland Park, IL 60035-4346
Phone (312) 404-4261
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36057770 | Medicaid | IL |
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 |
|---|---|---|---|
| 36057770 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1912974684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 POPLAR RD",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600354346",
"telephone_number": "312-404-4261",
"fax_number": "708-202-2085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 POPLAR RD",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600354346",
"telephone_number": "312-404-4261",
"fax_number": "708-202-2085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "BRUCE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-02",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "36057770",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "36057770",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.