STEPHANIE L ROTH (NPI# 1720254857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720254857 |
| Entity Type | Individual |
| Full Name | STEPHANIE L ROTH |
| Credential | LCPC |
| Practice Address |
5710 N Broadway St Chicago IL 60660-4302 |
| Practice Telephone | 7737281000 |
| Mailing Telephone | 7737281000 |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2008-05-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180.006723 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 180.006723 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043774268 | Stephanie Ramsey Roth | Clinical Exercise Physiologist | 2912 Oak Lake Blvd, Midlothian, VA 23112-3998 | 2019-01-23 |
| 1235314147 | Stephanie A. Roth | Podiatrist | 703 W Main St, Russellville, AR 72801-3616 | 2008-01-09 |
| 1528022472 | Stephanie Diane Roth | Family Medicine | 1335 E Whitestone Blvd, Cedar Park, TX 78613-7598 | 2006-04-15 |
| 1770052219 | Stephanie R Roth | Case Manager/Care Coordinator | 1010 E West Maple Rd, Walled Lake, MI 48390-3571 | 2018-11-14 |
| 1023461613 | Stephanie Roth | Physical Therapy Assistant | 800 Hausman Rd, Allentown, PA 18104-9393 | 2016-07-19 |
| 1790176675 | Stephanie Roth | Physical Therapist | 390 Orbiting Dr, Mosinee, WI 54455-1763 | 2015-02-12 |
| 1235531716 | Stephanie Roth | Social Worker | 441 W End Ave, Suite 1d, New York, NY 10024-5326 | 2014-09-16 |
| Street Address |
5710 N BROADWAY ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60660-4302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184639866 | Izabella Sisarica | Counselor | 5710 N Broadway St, Chicago, IL 60660-4302 | 2006-07-30 |
| 1508429705 | Annette Iskra | Social Worker | 5710 N Broadway St, Chicago, IL 60660-4302 | 2019-04-15 |
| 1487132221 | Kaytlin Dae-joyce Moore | Counselor | 5710 N Broadway St, Chicago, IL 60660-4302 | 2018-08-03 |
| 1699253872 | Meghan Simonett | Counselor | 5710 N Broadway St, Chicago, IL 60660-4302 | 2018-07-31 |
| 1073090684 | Mindy Dardon | Counselor | 5710 N Broadway St, Chicago, IL 60660-4302 | 2018-07-26 |
| 1942791777 | Johana D Hernandez | Registered Nurse | 5710 N Broadway St, Chicago, IL 60660-4302 | 2018-05-29 |
| 1346770138 | Rebekah T Sachdeva | Counselor | 5710 N Broadway St, Chicago, IL 60660-4302 | 2017-06-14 |
| 1164963237 | Micah Shapiro | Social Worker | 5710 N Broadway St, Chicago, IL 60660-4302 | 2017-03-09 |
| 1972054294 | Justin Kozak | Counselor | 5710 N Broadway St, Chicago, IL 60660-4302 | 2016-10-21 |
| 1295106573 | Ruth Solomon Tupper | Registered Nurse | 5710 N Broadway St, Chicago, IL 60660-4302 | 2015-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225672280 | Alexis Shelton | Behavior Technician | 6317 N Broadway, Chicago, IL 60660 | 2019-11-03 |
| 1912470105 | Pipeline - Lakefront Medical Associates, LLC | Family Medicine | 6201 North Broadway, Chicago, IL 60660 | 2019-01-10 |
| 1417492224 | Aynur Fataliyeva | Non-emergency Medical Transport (VAN) | 5701 N Sheridan Road, Apt 20g, Chicago, IL 60660 | 2017-01-03 |
| 1285187591 | Bryan Moles | Developmental Therapist | 6157 N Kenmore, Apt #4s, Chicago, IL 60660 | 2016-08-03 |
| 1144609181 | Ebm Consulting LLC | Anesthesiology | 5600 N Sheridan Road, #115, Chicago, IL 60660 | 2015-05-22 |
| 1295134112 | Brent E Agran, Dds, LLC | Dentist | 5820 N. Clark St., 1s, Chicago, IL 60660 | 2014-08-15 |
| 1538573258 | Emily Eaton | Student in an Organized Health Care Education/Training Program | 5643 N. Magnolia Ave, Chicago, IL 60660 | 2014-06-20 |
| 1538572664 | Rozina Altaf Virani | Nurse Practitioner | 6033 N Sheridan Rd Ste N6, Chicago, IL 60660 | 2014-06-05 |
| 1548673866 | Emily Mckernan | Social Worker | 5710 N Broadway Ave, Chicago, IL 60660 | 2014-06-04 |
| 1679902324 | Christopher Burgess | Psychologist | 1554 W Hollywood, #storefront, Chicago, IL 60660 | 2013-11-04 |
| Find all providers in zip 60660 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1073114591 | Alternative Schools Network | Counselor | 1807 W Sunnyside Ave, Chicago, IL 60640-5898 | 2020-11-02 |
| 1992306518 | Gravity and Grace Psychotherapy, Pllc | Counselor | 1305 S Michigan Ave Apt 602, Chicago, IL 60605-3398 | 2020-11-02 |
| 1811597263 | April Wilburne | Counselor | 804 E 54th St Apt 3, Chicago, IL 60615-4972 | 2020-10-27 |
| 1043810393 | Pamela Kranyak | Counselor | 30 N Michigan Ave Ste 925, Chicago, IL 60602-3463 | 2020-10-27 |
| 1003413378 | Erika Aguirre | Counselor | 5040 S Keating Ave., Chicago, IL 60632-4919 | 2020-10-08 |
| 1497361661 | Michael V Biederman | Counselor | 4254 N Mozart St Apt 2s, Chicago, IL 60618-1784 | 2020-09-22 |
| 1013523984 | Antionette Fisher | Counselor | 5703 S Peoria St, Chicago, IL 60621-2262 | 2020-09-16 |
| 1114532561 | Nefesh Counseling, LLC | Counselor | 3320 W Foster Ave # 124, Chicago, IL 60625-4813 | 2020-09-12 |
| 1114531043 | Katherine E Evans | Counselor | 1528 W Jonquil Ter Unit 2c, Chicago, IL 60626-5932 | 2020-09-08 |
| 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.