Roth, David
Roth, David is an individual health care provider with primary practice located at 2800 W 95Th St , Evergreen Park IL 60805-2746. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Roth, David can be contacted via phone (708) 422-6200.Contact Information
Primary practice address
2800 W 95Th St
Evergreen Park IL 60805-2746
Phone: (708) 422-6200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 036067777 | Illinois |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 036067777 | Illinois |
Profile Details
| NPI number | 1902838766 |
|---|---|
| LBN Legal business name | Roth, David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Jun 23rd, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902838766 | NPPES |
| Illinois | MEDICAID | 036067777 |
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