Roth, Jeffrey David

Roth, Jeffrey David is an sole proprietor health care provider with primary practice located at 25 E Washington St Suite 1811, Chicago IL 60602-1708. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Psychiatry, which is considered as his primary health care specialty. Roth, Jeffrey David can be contacted via phone (312) 444-1041.

Contact Information

Primary practice address
25 E Washington St Suite 1811 Chicago IL 60602-1708
Phone: (312) 444-1041
Fax: (312) 444-1048
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X Illinois

Profile Details

NPI number 1396752721
LBN Legal business name Roth, Jeffrey David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2006
Last updated Jul 8th, 2007 - about 17 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 1396752721 NPPES
Illinois Other 0031600526 BC/BS

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