Individual
DR. ROGER RODBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1426 W WASHINGTON BLVD, CHICAGO, IL 60607-1821
(312) 829-1424
(312) 850-8431
Mailing address
1426 W WASHINGTON BLVD, CHICAGO, IL 60607-1821
(312) 829-1424
(312) 850-8431
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036070596
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01615381
BC/BS ID NUMBER
IL
05
—
036070596
—
IL
01
—
110042308
RR MEDICARE
GA
Enumeration date
08/24/2006
Last updated
09/25/2012
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