Healthcare Provider Details

I. General information

NPI: 1770633430
Provider Name (Legal Business Name): STEVEN E ROTHKE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SKOKIE BOULEVARD SUITE 602
NORTHBROOK IL
60062-7914
US

IV. Provider business mailing address

450 SKOKIE BOULEVARD SUITE 602
NORTHBROOK IL
60062-7914
US

V. Phone/Fax

Practice location:
  • Phone: 847-480-5744
  • Fax: 847-480-5755
Mailing address:
  • Phone: 847-480-5744
  • Fax: 847-480-5755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: