DR. JEFFREY DAVID ROTH (NPI# 1396752721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396752721 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY DAVID ROTH |
| Credential | MD |
| Practice Address |
25 E Washington St Suite 1811 Chicago IL 60602-1708 |
| Practice Telephone | 3124441041 |
| Practice Fax Number | 3124441048 |
| Mailing Telephone | 3124441041 |
| Mailing Fax Number | 3124441048 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BC/BS | 0031600526 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386966653 | Jeffrey Eugene Roth | Pharmacist | 4041 Washington Rd, Mc Murray, PA 15317-2520 | 2010-02-26 |
| 1871629006 | Jeffrey M Roth | Physical Therapist | 9004 Woodview Dr, Pittsburgh, PA 15237-4163 | 2007-02-23 |
| 1144399189 | Jeffrey R Roth | Dentist | 408 S Main St Ste 1, Hailey, ID 83333-8402 | 2006-11-06 |
| 1699862219 | Jeffrey D Roth | Social Worker | 333 N Washington, Ste 260, Hutchinson, KS 67501 | 2006-10-06 |
| 1437196631 | Jeffrey M Roth | Optometrist | 725 Erie Blvd W, Syracuse, NY 13204-2229 | 2006-05-31 |
| 1932109212 | Jeffrey Joseph Roth | Plastic Surgery | 9280 W Sunset Rd Ste 236, Las Vegas, NV 89148-4861 | 2005-07-28 |
| 1326255340 | Jeffrey Lewis Roth | Dentist | Cmr 454, Box 1272, Apo, AE 09250-1272 | 2007-05-17 |
| 1598886558 | Jeffrey Roth | Counselor | 240 N James St, Suites 104-106, Wilmington, DE 19804-3169 | 2007-04-03 |
| 1184734584 | Jeffrey A Roth | Internal Medicine | 6600 Madison St, New Port Richey, FL 34652-1971 | 2006-08-30 |
| 1902868201 | Jeffrey Clark Roth | Internal Medicine | 2600 Redondo Ave, Long Beach, CA 90806-2329 | 2006-04-04 |
| Street Address |
25 E WASHINGTON ST SUITE 1811 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60602-1708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245227867 | Lawrence H Zager | Dentist | 25 E Washington St, # 825, Chicago, IL 60602-1708 | 2005-09-29 |
| 1417442021 | William David Ewing IIi | Counselor | 25 E Washington St, Chicago, IL 60602-1708 | 2018-06-26 |
| 1609379635 | Richla Davis | Counselor | 25 E Washington St, Chicago, IL 60602-1708 | 2018-03-15 |
| 1548785769 | Ida D Andarge | Social Worker | 25 E Washington St, Chicago, IL 60602-1708 | 2017-08-09 |
| 1326577362 | Asa Derrick Carson | Dentist | 25 E Washington St, Chicago, IL 60602-1708 | 2017-06-05 |
| 1023544731 | Speak Chicago Psychotherapy LLC | Social Worker | 25 E Washington St, Suite 1908, Chicago, IL 60602-1708 | 2017-05-02 |
| 1427583830 | Hannah Smith Therapy and Wellness | Marriage & Family Therapist | 25 E Washington St, Suite 1225, Chicago, IL 60602-1708 | 2017-04-23 |
| 1801328588 | Katelyn Schmitt | Counselor | 25 E Washington St, Suite 2036, Chicago, IL 60602-1708 | 2017-03-31 |
| 1255871083 | Equilibrium Counseling Center | Clinic/Center | 25 E Washington St, Suite 1724, Chicago, IL 60602-1708 | 2017-02-27 |
| 1336688902 | Julia Meo | Counselor | 25 E Washington St, #2036, Chicago, IL 60602-1708 | 2017-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710539705 | Biyang Wang | Social Worker | 9 W Washington St, Chicago, IL 60602 | 2019-07-10 |
| 1538724349 | Megan Asta Sarasek | Social Worker | 134 N Lasalle Street, Suite 400, Chicago, IL 60602 | 2019-05-07 |
| 1659850691 | Sara Chen | Dentist | 105 West Madison, 3rd Floor, Chicago, IL 60602 | 2018-08-10 |
| 1942795059 | Pratiti Rajeshkumar Gandhi | Dentist | 33 N Dearborn St Ste 2400, Chicago, IL 60602 | 2018-06-30 |
| 1154833994 | Ywca Metropolitan Chicago | Counselor | 1 North Lasalle Street, Suite 1150, Chicago, IL 60602 | 2017-11-02 |
| 1013434620 | Michelle Malters | Counselor | 30 N Michigan Ave Ste 1909, Chicago, IL 60602 | 2017-08-24 |
| 1740729474 | Jd Manikowski, D.d.s., LLC | Health Maintenance Organization | 30 N. Michigan Ave #1520, Chicago, IL 60602 | 2017-02-14 |
| 1568909943 | Pratiksha Agrawal | Dentist | 105 W Madison St Fl 3, Chicago, IL 60602 | 2017-01-24 |
| 1790221521 | Anastasia Scangas | Social Worker | 30 N Michigan Ave Ste 826, Chicago, IL 60602 | 2017-01-18 |
| 1194269837 | Jenna Peterson | Psychologist | 111 N Wabash Ave Ste 822, Chicago, IL 60602 | 2016-12-15 |
| Find all providers in zip 60602 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013141803 | Ishani Harsh Dalal | Psychiatry & Neurology | 680 N Lake Shore Dr Ste 800, Chicago, IL 60611-8701 | 2009-05-07 |
| 1790953388 | Sarz Maxwell | Psychiatry & Neurology | 1020 W Ardmore Ave, #104, Chicago, IL 60660-3700 | 2008-02-15 |
| 1588872055 | Babatunde Gbolade Okuleye | Psychiatry & Neurology | 200 S Michigan Avenue, Suite 710, Chicago, IL 60604-2403 | 2007-05-18 |
| 1134243942 | Sheldon S. Greenberg, M.d., S.c. | Psychiatry & Neurology | 2835 North Sheffield Ave., Suite 200, Chicago, IL 60657-5083 | 2007-03-19 |
| 1851645964 | Pilsen Psychiatric Clinic & Associates, LLC | Psychiatry & Neurology | 1870 S Blue Island Ave, Chicago, IL 60608-3013 | 2012-10-29 |
| 1417225152 | Anish John | Psychiatry & Neurology | 680 N Lake Shore Dr Ste 800, Chicago, IL 60611-8701 | 2011-12-08 |
| 1356633192 | Sree Harsha Katragadda | Psychiatry & Neurology | 912 S Wood St, Chicago, IL 60612-4300 | 2011-05-12 |
| 1255586103 | Benjamin Stephan | Psychiatry & Neurology | 2525 S Michigan Ave, B-522, Chicago, IL 60616-2333 | 2008-11-19 |
| 1629190665 | Virgilio Arenas | Psychiatry & Neurology | 1901 W Harrison St, Chicago, IL 60612-3714 | 2007-04-03 |
| 1154407658 | Joe Nathaniel Sangster Sr. | Psychiatry & Neurology | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-10-27 |
| Find all providers in CHICAGO | ||||
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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.