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NPI 1235120452

NPI 1235120452 : ALAN S. ROTHSTEIN D.P.M. : NORTHBROOK, IL

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General NPI Number Information
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    NPI Number           |    1235120452
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    Entity Type          |    Individual 
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    Provider Name        |    ALAN S. ROTHSTEIN D.P.M.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/04/2005
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    Last Update Date     |    05/09/2017
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Provider Practice Location Address
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    Address Line         |    425 HUEHL RD UNIT 13 
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    City                 |    NORTHBROOK
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    State                |    IL
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    Zip                  |    60062-2319
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    Country              |    US
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    Telephone            |    847-504-5000
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    Fax                  |    844-443-0082
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Provider Business Mailing Address
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    Address Line         |    425 HUEHL RD UNIT 13 
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    City                 |    NORTHBROOK
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    State                |    IL
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    Zip                  |    60062-2319
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    Country              |    US
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    Telephone            |    847-504-5000
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    Fax                  |    844-443-0082
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    213E00000X
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    Taxonomy Name        |    Podiatrist
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    License Number       |    000448
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    License Number State |    GA
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