Individual
DR. JASON ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 W HARRISON ST STE 340, CHICAGO, IL 60612-3852
(312) 664-6715
(312) 563-0165
Mailing address
225 N COLUMBUS DR APT 4912, CHICAGO, IL 60601-5232
(630) 574-8222
(630) 574-1516
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
125060683
IL
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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