MEDICARE: DR. JENNIFER ROTHKOPF 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	2084P0800X	Psychiatry Physician	036-099665	IL

General Provider Information

NPI Number	:	1881710846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER ROTHKOPF M.D.

Provider Business Mailing Address
First Line	:	1841 W CORNELIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1019
Country	:	US
Telephone Number	:	773-332-9597
Fax Number	:

Provider Business Practice Location Address
First Line	:	1841 W CORNELIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1019
Country	:	US
Telephone Number	:	773-332-9597
Fax Number	:

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	05/21/2025

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