National Provider Identifier Database

TERRY ROTH
Neurology

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.


Contact Information

TERRY ROTH
4920 EAST STATE ST
ROCKFORD, IL61108
Phone: 815-226-1906
Fax: 815-226-8474
Website:
Specialty Taxonomy Code
* Neurology 2084N0400X

* Indicates primary specialty

NPI Profile & details for TERRY ROTH

NPI Number 1215919816
Credentials
Entity Individual
Enumeration date 11/18/2005
Last updated 05/22/2008 - About 18 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 36059503
  • IL Medicaid: 036059503
  • IL Other: 0010100550 BCBS
  • IL Other: 009771 HEALTH ALLIANCE
  • IL Other: 791133579 RETIRED RAILROAD
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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