Dr. James Gerard Roth
Optometrist
6857 S Pulaski Rd
Chicago
, Illinois 60629-4151
Dr. James Gerard Roth
Optometrist
6857 S Pulaski Rd
Chicago
, Illinois 60629-4151
(773) 767-5176
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. James Gerard Roth
- 6857 S Pulaski Rd
- Chicago, IL
- Zip : 60629-4151
- Fax : (773) 767-5176
- Phone : (773) 767-5000
Second Address
- Dr. James Gerard Roth
- 6857 S Pulaski Rd
- Chicago, IL
- Zip : 60629-4151
- Fax : (773) 767-5176
- Phone : (773) 767-5000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046008029 | IL |
National Provider Identifier
| NPI | 1013071075 |
|---|---|
| Provider Name | Dr. James Gerard Roth |
| First Address | Chicago, IL 60629-4151 |
| Second Address | Chicago, IL 60629-4151 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/12/2006 |
| Last Update Date | 09/10/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 046008029 | (05) | IL |
| 08127171 | BCBS OF IL (01) | IL |
| T36573 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.