Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenrick L Roberts, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1265754329

Kenrick L Roberts, PHYSICIANASSISTANT is a Physician Assistant in Evergreen Park, Illinois. Qualified in 2008, 18 years ago. Practices with Cook County, a 787-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
18
Licensed in
IL
In the registry since
2010
Specialties on file
3

Practice location Address checks out

2850 W 95th St Ste 301
Evergreen Park, IL 60805-2735
Phone: (708) 389-2200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-003520 (IL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 085003520 (IL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 085003520 (IL)

Record details

NPI number1265754329
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedFebruary 17, 2010
Last updated in NPPESApril 29, 2021
Certification dateApril 29, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Cook County — 787 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Evergreen Park