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Individual

ALAN MARSHALL ROMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2320 HIGH ST, BLUE ISLAND, IL 60406-2426
(708) 388-5500
(708) 388-5672
Mailing address
2320 HIGH ST, BLUE ISLAND, IL 60406-2426
(708) 388-5500
(708) 388-5672

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036060612
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020036557
RAILROAD MEDICARE
IL
05
036060612
IL
Enumeration date
04/17/2006
Last updated
05/16/2016
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