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NPI Code Detail

MEDICARE: MICHELLE ROBERTS

MEDICARE: MICHELLE 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
1235Z00000XSpeech-Language Pathologist242.004609IL

General Provider Information

NPI Number : 1396250296
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE ROBERTS
Provider Business Mailing Address
First Line : 3125 W FULLERTON AVE APT 214
Second Line :
City : CHICAGO
State : IL
Zip : 60647-6959
Country : US
Telephone Number : 918-740-7768
Fax Number :
Provider Business Practice Location Address
First Line : 675 N SAINT CLAIR ST STE 15-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5967
Country : US
Telephone Number : 312-694-0285
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2017
Last Update Date : 06/12/2019

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Directions to “ MICHELLE ROBERTS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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