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NPI Code Detail

MEDICARE: HANNAH FAY ROTH MD

MEDICARE:   HANNAH FAY ROTH  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
1207RG0100XGastroenterology Physician036152813IL
2207RI0008XHepatology Physician036152813IL
3207R00000XInternal Medicine Physician036152813IL

General Provider Information

NPI Number : 1700315769
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH FAY ROTH MD
Provider Business Mailing Address
First Line : 180 HARVESTER DR STE 110
Second Line :
City : BURR RIDGE
State : IL
Zip : 60527-6686
Country : US
Telephone Number : 773-795-0232
Fax Number :
Provider Business Practice Location Address
First Line : 5841 S MARYLAND AVE STE MC7082
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1465
Country : US
Telephone Number : 773-795-0232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2017
Last Update Date : 02/11/2026

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Directions to “ HANNAH FAY ROTH MD” Practice Location

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