Organization
ROTH EYE CARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES GERARD ROTH O.D. (PRESIDENT)
(773) 767-5000
Entity
Organization
Contact information
Practice address
6857 S PULASKI RD, CHICAGO, IL 60629-4151
(773) 767-5000
(773) 767-5176
Mailing address
6857 S PULASKI RD, CHICAGO, IL 60629-4151
(773) 767-5000
(773) 767-5176
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008029
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008029
—
IL
Enumeration date
10/09/2008
Last updated
10/09/2008
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