Roth, Howard I

Roth, Howard I is an individual health care provider with primary practice located at 350 N Wall St , Kankakee IL 60901-2901. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Roth, Howard I can be contacted via phone (815) 933-1671.

Contact Information

Primary practice address
350 N Wall St Kankakee IL 60901-2901
Phone: (815) 933-1671
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036079163 Illinois
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 036079163 Illinois

Profile Details

NPI number 1043381239
LBN Legal business name Roth, Howard I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2006
Last updated Dec 4th, 2023 - about last year

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 1043381239 NPPES
Illinois MEDICAID 036079163
Illinois Other 4615054

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