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Bailey R Roth
Student in an Organized Health Care Education/Training Program in Bradley, Illinois
NPI 1952767782

Bailey R Roth is a Student in an Organized Health Care Education/Training Program based in Bradley, IL. Bailey R Roth practices in Bradley, IL. The NPI Number for Bailey R Roth is 1952767782 and holds a License No. 2255A2300X (Illinois).

The current practice location address for Bailey R Roth is 380 N Van Buren Ave, Bradley, IL and can be reached out via phone at 815-953-1019.

Location: 380 N Van Buren Ave, Bradley, IL, 60915-1486
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952767782
Provider Name
Bailey R Roth
Credential
Provider Entity Type
Individual
Gender
Female
Address
380 N Van Buren Ave, Bradley, IL, 60915-1486
Phone Number
815-953-1019
Fax Number
Provider Enumeration Date
01/08/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
380 N Van Buren Ave
City
Bradley
State
Illinois
Zip
60915-1486
Phone Number
815-953-1019
Fax Number
person
Provider Business Mailing Address Details
Address
380 N Van Buren Ave
City
Bradley
State
Illinois
Zip
60915-1486
Phone Number
815-953-1019
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
2255A2300X (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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