MEDICARE: MICHAEL H ROCK M.D.

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	207L00000X	Anesthesiology Physician	036078236	IL
2	208VP0014X	Interventional Pain Medicine Physician	036078236	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	364054341	OTHER	IL	COMMERCIAL INS.GROUP#
2	0001620300	OTHER	IL	BLUECROSS BLUESHILD OF IL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760596886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL H ROCK M.D.

Provider Business Mailing Address
First Line	:	1165 N CLARK ST
Second Line	:	SUITE 700
City	:	CHICAGO
State	:	IL
Zip	:	60610-2702
Country	:	US
Telephone Number	:	312-809-6500
Fax Number	:	312-809-6501

Provider Business Practice Location Address
First Line	:	6145 N NORTHWEST HWY
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-2127
Country	:	US
Telephone Number	:	312-809-6500
Fax Number	:	312-809-6501

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	12/06/2022

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Directions to “ MICHAEL H ROCK M.D.” Practice Location

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