Roger D Roberts
Optometrist
6601 N Avondale Ave Suite 102
Chicago
, Illinois 60631-1572
Roger D Roberts
Optometrist
6601 N Avondale Ave Suite 102
Chicago
, Illinois 60631-1572
(773) 889-0224
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Roger D Roberts
- 6601 N Avondale Ave Suite 102
- Chicago, IL
- Zip : 60631-1572
- Fax : (773) 889-0224
- Phone : (773) 792-1011
Second Address
- Roger D Roberts
- 6601 N Avondale Ave Suite 102
- Chicago, IL
- Zip : 60631-1572
- Fax : (773) 889-0224
- Phone : (773) 792-1011
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | IL |
National Provider Identifier
| NPI | 1003885138 |
|---|---|
| Provider Name | Roger D Roberts |
| First Address | Chicago, IL 60631-1572 |
| Second Address | Chicago, IL 60631-1572 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/03/2006 |
| Last Update Date | 22/11/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U50456 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.