TERRY ROTH (NPI# 1215919816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215919816 |
| Entity Type | Individual |
| Full Name | TERRY ROTH |
| Practice Address |
4920 East State St Rockford IL 61108 |
| Practice Telephone | 8152261906 |
| Practice Fax Number | 8152268474 |
| Mailing Telephone | 8152261906 |
| Mailing Fax Number | 8152268474 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2008-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
36059503 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036059503 | 05 | |
| IL | RETIRED RAILROAD | 791133579 | 01 |
| IL | HEALTH ALLIANCE | 009771 | 01 |
| IL | BCBS | 0010100550 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942557244 | Terry L Roth | Pharmacist | 2330 Hwy 93 N, Kalispell, MT 59901 | 2012-08-07 |
| 1083878508 | Terry L. Roth | Registered Nurse | 304 E Quail Wood Ln, Westfield, IN 46074-9038 | 2008-07-14 |
| Street Address |
4920 EAST STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740503960 | Yonghua Zhang | Psychiatry & Neurology | 535 Roxbury Road, Rockford, IL 61107-5076 | 2010-03-02 |
| 1275644254 | Faisal Majid Raja | Psychiatry & Neurology | 2350 N. Rockton Ave, Rockford Health Physicians, Rockford, IL 61103-3619 | 2006-08-31 |
| 1750344404 | John C Collins | Psychiatry & Neurology | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2006-04-11 |
| 1548243819 | Regina B Bielkus | Psychiatry & Neurology | 1055 Featherstone Rd, Suite C, Rockford, IL 61107-5904 | 2005-11-21 |
| 1770565905 | Madhav K Srivastava | Psychiatry & Neurology | 4920 E State St, Rockford, IL 61108-2272 | 2005-11-15 |
| 1376022350 | Atiq Urrehman Khan | Psychiatry & Neurology | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-08-09 |
| 1275864118 | Regina B Bielkus Md LLC | Psychiatry & Neurology | 1055 Featherstone Rd, Suite C, Rockford, IL 61107-5904 | 2010-01-15 |
| 1194965129 | Kevin Harold Ruggles | Psychiatry & Neurology | 2350 N Rockton Ave, Rockford, IL 61103-3600 | 2009-03-04 |
| 1811162712 | Preeti A Devnani | Psychiatry & Neurology | 1401 E State St, Rockford, IL 61104-2315 | 2008-04-23 |
| 1750434361 | Drs. Srivastava S.c. | Psychiatry & Neurology | 5668 E State St, Suite 2700, Rockford, IL 61108-2490 | 2007-01-18 |
| Find all providers in ROCKFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.