Individual
DR. CLIFFORD W. ROT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2604 DEMPSTER ST, SUITE 510, PARK RIDGE, IL 60068-8412
(847) 910-0182
Mailing address
1005 MEADOW LN, ELGIN, IL 60123-1429
(847) 910-0182
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-003583
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1673232
BC/BS PPO PROVIDER
IL
Enumeration date
07/26/2005
Last updated
06/01/2008
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