Healthcare Provider Details

I. General information

NPI: 1669113593
Provider Name (Legal Business Name): MEGAN LEIGH ROBERTS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE. EMERGENCY MEDICINE
EVANSTON IL
60201-1718
US

IV. Provider business mailing address

2650 RIDGE AVE SUITE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2114
  • Fax: 847-570-1223
Mailing address:
  • Phone: 847-570-2114
  • Fax: 847-570-1223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036175812
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: