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Contact Information

MARK A ROTERT, NP
420 N IL ROUTE 31
CRYSTAL LAKE, IL60012
 Phone: 815-788-2018
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for MARK A ROTERT · (Male)

NPI Number 1326483280
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 05/06/2013
Last updated 11/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 209019035
  • MO License # 2013013779
Hospital affiliation(s)
  • CENTEGRA HEALTH SYSTEM - MC HENRY HOSPITAL - (Acute Care)
    4201 MEDICAL CENTER DRIVE
    MCHENRY, IL 60050
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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