Healthcare Provider Details

I. General information

NPI: 1952550881
Provider Name (Legal Business Name): NEREIDA ROJAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 N SHERIDAN RD
CHICAGO IL
60613-2010
US

IV. Provider business mailing address

8630 W GOLF RD
NILES IL
60714-5600
US

V. Phone/Fax

Practice location:
  • Phone: 773-388-1600
  • Fax:
Mailing address:
  • Phone: 847-299-0009
  • Fax: 847-299-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number036131734
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: