Roth, Stephen
Roth, Stephen is an sole proprietor health care provider with primary practice located at 412 63Rd St Suite 105, Downers Grove IL 60516-2000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Roth, Stephen can be contacted via phone (630) 915-5437.Contact Information
Primary practice address
412 63Rd St Suite 105
Downers Grove IL 60516-2000
Phone: (630) 915-5437
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | Illinois |
Profile Details
| NPI number | 1629161401 |
|---|---|
| LBN Legal business name | Roth, Stephen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 2nd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629161401 | NPPES |
| Illinois | Other | 0021627803 | BLUE CROSS ID |
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