Roth, John B.
Roth, John B. is an sole proprietor health care provider with primary practice located at 107 W Jefferson St , Morris IL 60450-2128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Roth, John B. can be contacted via phone (815) 942-0683.Contact Information
Primary practice address
107 W Jefferson St
Morris IL 60450-2128
Phone: (815) 942-0683
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 036044899 | Illinois |
Profile Details
| NPI number | 1447396361 |
|---|---|
| LBN Legal business name | Roth, John B. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Sep 21st, 2011 - about 15 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 | 1447396361 | NPPES |
| Illinois | MEDICAID | 036044899 |
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