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Terry Roth
Neurology Physician in Rockford, Illinois
NPI 1215919816

Terry Roth is a Neurology Physician based in Rockford, IL and is specialized in Neurology. Terry Roth practices in Rockford, IL. The NPI Number for Terry Roth is 1215919816 and holds a License No. 36059503 (Illinois).

The current practice location address for Terry Roth is 4920 East State St, Rockford, IL and can be reached out via phone at 815-226-1906 and via fax at 815-226-8474.

Location: 4920 East State St, Rockford, IL, 61108
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215919816
Provider Name
Terry Roth
Credential
Provider Entity Type
Individual
Gender
Male
Address
4920 East State St, Rockford, IL, 61108
Phone Number
815-226-1906
Fax Number
815-226-8474
Provider Enumeration Date
11/18/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0010100550 01 IL BCBS
791133579 01 IL RETIRED RAILROAD
009771 01 IL HEALTH ALLIANCE
036059503 05 IL
institution
Provider Business Practice Location Address Details
Address
4920 East State St
City
Rockford
State
Illinois
Zip
61108
Phone Number
815-226-1906
Fax Number
815-226-8474
person
Provider Business Mailing Address Details
Address
4920 East State St
City
Rockford
State
Illinois
Zip
61108
Phone Number
815-226-1906
Fax Number
815-226-8474
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
2084N0400X
License No.
36059503 (Illinois)
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
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