MEDICARE: NADIA SHADEA ROBERTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	227034684	IL

General Provider Information

NPI Number	:	1225963176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA SHADEA ROBERTS

Provider Business Mailing Address
First Line	:	811 W MAXWELL ST RM 418B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1508
Country	:	US
Telephone Number	:	708-980-3180
Fax Number	:

Provider Business Practice Location Address
First Line	:	811 W MAXWELL ST RM 418B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1508
Country	:	US
Telephone Number	:	708-980-3180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ NADIA SHADEA ROBERTS ” Practice Location

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