Individual
DR. ROY JOSEPH BETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 N GARY AVE, WHEATON, IL 60187-3055
(630) 653-5115
(630) 653-4493
Mailing address
2001 N GARY AVE, WHEATON, IL 60187-3055
(630) 653-5115
(630) 653-4493
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36043734
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036043734
—
IL
01
—
920540
MEDICARE PTAN (GROUP)
IL
01
—
920540007
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
07/10/2006
Last updated
02/25/2014
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