Root, Jonathan D

Root, Jonathan D is an individual health care provider with primary practice located at 300 First Capitol Drive , St Charles MO 63301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Root, Jonathan D can be contacted via phone (636) 947-5444.

Contact Information

Primary practice address
300 First Capitol Drive St Charles MO 63301
Phone: (636) 947-5444
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X R8F12 Missouri
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036086602 Illinois

Profile Details

NPI number 1033139696
LBN Legal business name Root, Jonathan D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033139696 NPPES
Illinois MEDICAID 036086602
Illinois Other 300102466
Illinois MEDICAID 203143300
Illinois Other 300102481

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