Active NPI
Roberta White, LMT
- Massage Therapist
- Round Lake Beach, IL
National Provider Identifier
1972990646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227-011753
- Practice address
- 301 E Rollins Rd
Round Lake Beach, IL 60073-1331 - Phone
- (847) 201-7612
- Fax
- (847) 201-7613
- NPI assigned
- Apr 21, 2015
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227-011753 | IL | Primary |
Addresses
Primary practice location
301 E Rollins Rd
Round Lake Beach, IL 60073-1331
Mailing address
301 E Rollins Rd
Round Lake Beach, IL 60073-1331
Phone (847) 201-7612
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
| License | State | Type | Specialty |
|---|---|---|---|
| 227-011753 | IL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake County Physical Therapy LLC | Past | 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.
-
- Physical Therapist
- Mundelein, IL
- NPI 1851487581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429574400000",
"number": "1972990646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E ROLLINS RD",
"city": "ROUND LAKE BEACH",
"state": "IL",
"postal_code": "600731331",
"telephone_number": "847-201-7612",
"fax_number": "847-201-7613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E ROLLINS RD",
"city": "ROUND LAKE BEACH",
"state": "IL",
"postal_code": "600731331",
"telephone_number": "847-201-7612",
"fax_number": "847-201-7613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "ROBERTA",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-21",
"last_updated": "2015-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227-011753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Lake Beach, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.