Individual
STEVEN ROAT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
5409 N KNOXVILLE AVE, PEORIA, IL 61615
(309) 682-7750
(309) 682-7786
Mailing address
PO BOX 3853, PEORIA, IL 61612-3853
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007222342
BLUE CROSS BLUE SHIELD
IL
05
—
036098574-2
—
IL
01
—
3701083
ACR
IL
01
—
417693
HEALTHLINK
IL
01
—
IL0100
JOHN DEERE
IL
Enumeration date
01/04/2006
Last updated
07/08/2007
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