Healthcare Provider Details

I. General information

NPI: 1568490381
Provider Name (Legal Business Name): LOUIS ROHR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 W CHICAGO AVE
CHICAGO IL
60651-3223
US

IV. Provider business mailing address

4800 W CHICAGO AVE
CHICAGO IL
60651-3223
US

V. Phone/Fax

Practice location:
  • Phone: 773-826-9600
  • Fax:
Mailing address:
  • Phone: 773-286-9600
  • Fax: 773-826-9601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036102555
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: