Individual
EBONY ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16541 OAK PARK AVE, TINLEY PARK, IL 60477-1752
(708) 580-6165
Mailing address
15811 CENTRAL AVE UNIT 84, OAK FOREST, IL 60452-7604
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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