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General NPI Number Information
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NPI Number | 1548291966
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Entity Type | Organization
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Legal Business Name | DAVID A ROTHSTEIN MD SC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2851 W BRYN MAWR
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City | CHICAGO
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State | IL
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Zip | 60659-4810
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Country | US
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Telephone | 312-339-1810
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Fax | 773-271-8683
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Provider Business Mailing Address
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Address Line | PO BOX 597525
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City | CHICAGO
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State | IL
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Zip | 60659-7525
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Country | US
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Telephone | 312-339-1810
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Fax | 773-271-8683
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. DAVID A ROTHSTEIN
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Credential | MD
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Telephone | 312-339-1810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | IL
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