MEDICARE: DR. ITAI ROZOVSKY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD035598E	PA
2	2083P0901X	Public Health & General Preventive Medicine Physician	036083229	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720301690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ITAI ROZOVSKY M.D.

Provider Business Mailing Address
First Line	:	113 MCHENRY RD STE 240
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1796
Country	:	US
Telephone Number	:	224-770-1503
Fax Number	:	609-739-8440

Provider Business Practice Location Address
First Line	:	113 MCHENRY RD STE 240
Second Line	:
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-1796
Country	:	US
Telephone Number	:	224-770-1503
Fax Number	:	609-739-8440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2010
Last Update Date	:	06/07/2026

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