Roche, Therese

Roche, Therese is an individual health care provider with primary practice located at 1900 Silver Cross Blvd , New Lenox IL 60451-9509. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Roche, Therese can be contacted via phone (815) 300-1100.

Contact Information

Primary practice address
1900 Silver Cross Blvd New Lenox IL 60451-9509
Phone: (815) 300-1100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209.006815 Illinois

Profile Details

NPI number 1740460286
LBN Legal business name Roche, Therese
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2007
Last updated Apr 20th, 2020 - about 4 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 1740460286 NPPES
Illinois Other P00608770 RR MEDICARE GROUP NUMBER

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