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General NPI Number Information
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NPI Number | 1801554118
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Entity Type | Individual
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Provider Name | TOVAH RACHAEL ROBERTS NP
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Gender | Female
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Dates
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Enumeration Date | 12/03/2021
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 5841 S MARYLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60637-1443
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Country | US
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Telephone | 773-702-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 680 N LAKE SHORE DR APT 605
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City | CHICAGO
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State | IL
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Zip | 60611-4474
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Country | US
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Telephone | 773-964-3355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 041.424882
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | 209.025611
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License Number State | IL
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