Individual
DR. J. ROMAINE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1229 N NORTH BRANCH ST, CHICAGO, IL 60642-2473
(312) 445-5673
(312) 284-4755
Mailing address
1229 N NORTH BRANCH ST, CHICAGO, IL 60642-2473
(312) 445-5673
(312) 284-4755
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
D59996
MD
207QG0300X
Geriatric Medicine (Family Medicine) Physician
0101233240
IN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
036.073364
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
512302001
—
MD
01
—
J784-0001
BC/BS
MD
Enumeration date
12/07/2005
Last updated
10/18/2010
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