MEDICARE: JODI M ROQUE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	190472	NC
2	207Q00000X	Family Medicine Physician	LP01622	RI
3	207Q00000X	Family Medicine Physician	036158109	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MD13982	OTHER	RI	MEDICAL LICENSE

General Provider Information

NPI Number	:	1346478526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODI M ROQUE MD

Provider Business Mailing Address
First Line	:	PO BOX 746715
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6715
Country	:	US
Telephone Number	:	773-352-1515
Fax Number	:	312-929-0373

Provider Business Practice Location Address
First Line	:	1819 N HARLEM AVE STE A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60707-3716
Country	:	US
Telephone Number	:	773-589-4385
Fax Number	:	872-228-8601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2009
Last Update Date	:	06/10/2025

Similar Medicare Providers

1508841982 — DR. BEATRIZ HUERTAS RIVERA M.D.
Practice Location Address:

1819 N HARLEM AVE STE A
CHICAGO, IL
60707-3716

Practice Phone: 773-589-4385
Practice Fax: 872-228-8601

1699717884 — HIGHLAND PARK CVS LLC
Practice Location Address:

1819 N HARLEM AVE
CHICAGO, IL
60707-3716

Practice Phone: 773-237-8927
Practice Fax:

1699370650 — PAUL BELCHAK
Practice Location Address:

1819 N HARLEM AVE
CHICAGO, IL
60707-3716

Practice Phone: 773-237-8927
Practice Fax:

1609440015 — CAROLYN D RETTERER MS,RPH
Practice Location Address:

1819 N HARLEM AVE
CHICAGO, IL
60707-3716

Practice Phone: 773-237-8927
Practice Fax: 773-237-9037

1508539743 — PATRYCJA M KLIS
Practice Location Address:

1819 N HARLEM AVE
CHICAGO, IL
60707-3716

Practice Phone: 773-237-8927
Practice Fax:

1285333039 — VANDERBILT HOME CARE CORP
Practice Location Address:

1807 N HARLEM AVE
CHICAGO, IL
60707-3716

Practice Phone: 708-477-3033
Practice Fax:

Directions to “ JODI M ROQUE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.