Individual
ETHAN R ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1915 S ARCHER AVE, CHICAGO, IL 60616-1618
(312) 674-9132
(312) 674-9392
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056014948
IL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
06/15/2022
Last updated
07/18/2022
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