# ROGER B TRAYCOFF

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1528078540
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036051951 | IL | — |
| 207RR0500X | Rheumatology Physician | 036051951 | IL | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 12/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 020057300 | BLACK LUNG | IL |
| 01 | — | 029224 | HEALTH ALLIANCE | IL |
| 01 | — | 036051951 | IL STATE LICENSE | IL |
| 05 | — | 036051951 | — | IL |
| 01 | — | 08421024 | BC/BS | IL |
| 01 | — | 133586700 | ACS-OWCP | IL |
| 01 | — | 14D0949277 | CLIA | IL |
| 01 | — | 194883 | PERSONAL CARE | IL |
| 01 | — | 206164 | HEALTHLINK | IL |
| 01 | — | CATERPILLAR | 6394P | IL |
| 01 | — | CD7143 | RR MEDICARE GROUP | IL |
| 01 | — | P00144541 | RR MEDICARE PIN | IL |