Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 125052813 | IL |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 125052813 | IL |
NPI | 1003062514 |
---|---|
Provider Name | Dr. David William Roberts |
First Address | Skokie, IL 60076-1214 |
Second Address | Skokie, IL 60076-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2008 |
Last Update Date | 16/02/2021 |