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Individual
TIMOTHY MARK ROOS
Active
Individual
TIMOTHY MARK ROOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.072962
IL
208000000X
Pediatrics Physician
125.072962
IL
208M00000X
Hospitalist Physician
Primary
MD209619
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500807433
—
OR
Enumeration date
06/20/2018
Last updated
07/20/2022
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