MEDICARE: ELVI ROCI DMD

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	1223G0001X	General Practice Dentistry	019036802	IL

General Provider Information

NPI Number	:	1699487058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELVI ROCI DMD

Provider Business Mailing Address
First Line	:	1440 W FILLMORE ST UNIT 504
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-5212
Country	:	US
Telephone Number	:	267-304-5483
Fax Number	:

Provider Business Practice Location Address
First Line	:	4641 W DIVERSEY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-1828
Country	:	US
Telephone Number	:	773-692-4147
Fax Number	:

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

Provider Enumeration Date	:	12/16/2022
Last Update Date	:	02/04/2026

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