Healthcare Provider Details

I. General information

NPI: 1124058920
Provider Name (Legal Business Name): ID CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 ENTERPRISE PKWY STE 110
BEACHWOOD OH
44122-7340
US

IV. Provider business mailing address

1726 COLE BLVD STE 250
LAKEWOOD CO
80401-3262
US

V. Phone/Fax

Practice location:
  • Phone: 216-448-1060
  • Fax: 216-450-1031
Mailing address:
  • Phone: 855-478-1528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUE ELLEN ROTTURA
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 561-323-8987