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Individual

MR. STEVEN D ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC/LAT

Contact information

Practice address
15635 S 94TH AVE, ORLAND PARK, IL 60462-4722
(708) 460-8588
(708) 460-8788
Mailing address
8616 WASHINGTON AVE, BROOKFIELD, IL 60513-1423
(708) 906-8985
(708) 460-8788

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
IL

Other

Enumeration date
08/04/2006
Last updated
07/08/2007
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