Roth, Adele M.

Roth, Adele M. is an individual health care provider with primary practice located at 2900 Frank Scott Pkwy W Suite 980, Belleville IL 62223-5000. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Roth, Adele M. can be contacted via phone (618) 234-9200.

Contact Information

Primary practice address
2900 Frank Scott Pkwy W Suite 980 Belleville IL 62223-5000
Fax: (618) 234-3940
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036069016 Illinois

Profile Details

NPI number 1750480356
LBN Legal business name Roth, Adele M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated May 24th, 2021 - about 3 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 1750480356 NPPES
Illinois MEDICAID 036069016

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