Doctor Name: | A JERALD ROTHENBERG |
NPI Number: | 1184683765 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036-039336 |
Business Practice Address: | 2270 Arbeleda Ln Northbrook, IL - 60062 |
Business Phone Number: | 8472542453 |
Business Fax Number: | |
Mailing Address: | 2270 Arbeleda Ln, Suite 408 NORTHBROOK |
State: | IL |
Postal Code: | 600627605 |
Phone Number: | 8478666600 |
Fax Number: | 8474756835 |
NPI Enumeration Date: | 03/21/2006 |
NPI Last Update Date: | 03/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036-039336 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |