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BRADFORD C ROBERG M.D.
NPI 1316946072
Surgery - Plastic and Reconstructive Surgery in Crystal Lake, IL

Active since July 15, 2005PECOS Enrolled
5714 S STATE ROUTE 31, CRYSTAL LAKE, IL 60014(815) 356-7000(815) 356-7513 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Bradford C Roberg M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADFORD C ROBERG M.D. (NPI 1316946072) is an individual plastic and reconstructive surgery provider in Crystal Lake, Illinois and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316946072
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameBRADFORD C ROBERGCredential: M.D.
Location Address5714 S STATE ROUTE 31Crystal Lake, IL 60014-4520
Mailing Address8135 N Milwaukee AveNiles, IL 60714-2828 · (847) 967-8098 · Fax (847) 967-8594
Phone(815) 356-7000
Fax(815) 356-7513
Sole ProprietorYes
Enumeration DateJuly 15, 2005
Last NPPES UpdateJuly 8, 2007
✔ NPI 1316946072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Definition
A surgeon who specializes in plastic and reconstructive surgery.
5714 S STATE ROUTE 31, Crystal Lake, IL 60014
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Other Identifiers 3

Other00732007IL · Blue Shield Of Illinois
Medicare ID-Type Unspecified319960IL
Medicare UPINC75640IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradford C Roberg M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradford Roberg's NPI number?

The NPI number for Bradford Roberg is 1316946072. It was assigned to this individual provider in the NPPES registry on July 15, 2005.

Where is Bradford Roberg located?

Bradford Roberg practices at 5714 S State Route 31, Crystal Lake, IL 60014. The listed phone number is (815) 356-7000.

What is Bradford Roberg's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Bradford Roberg enrolled in Medicare?

Yes. Bradford Roberg is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bradford Roberg was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.