NPI 1013071075

James Gerard Roth, OD

Practitioner Optometrist Chicago, IL

Practice location

Address: 6857 S Pulaski Rd, Chicago, IL 60629-4151
Phone: (773) 767-5000
Fax: (773) 767-5176

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 046008029 (IL)

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Registry record

NPI: 1013071075
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Dec 2006
Record last updated: 9 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.