Basic Information
| Provider Information | |||||||||
| NPI: | 1003062514 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBERTS | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9650 GROSS POINT RD | ||||||||
| Address2: | SUITE 2900 | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600761214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478667846 | ||||||||
| FaxNumber: | 2242512905 | ||||||||
| Practice Location | |||||||||
| Address1: | 9650 GROSS POINT RD | ||||||||
| Address2: | SUITE 2900 | ||||||||
| City: | SKOKIE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600761214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478667846 | ||||||||
| FaxNumber: | 2242512905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2008 | ||||||||
| LastUpdateDate: | 02/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 125052813 | IL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XP3100X | 125052813 | IL | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Pediatric Orthopaedic Surgery |
No ID Information.