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NPI Code Detail

MEDICARE: DR. ROGER PEYTON PLOTKIN M.D.

MEDICARE:  DR. ROGER PEYTON PLOTKIN  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
1207Y00000XOtolaryngology PhysicianIL

General Provider Information

NPI Number : 1770706798
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER PEYTON PLOTKIN M.D.
Provider Business Mailing Address
First Line : 1319 CHICAGO AVE
Second Line : SUITE 405
City : EVANSTON
State : IL
Zip : 60201-5303
Country : US
Telephone Number : 847-570-9359
Fax Number : 847-570-9510
Provider Business Practice Location Address
First Line : 1319 CHICAGO AVE
Second Line : SUITE 405
City : EVANSTON
State : IL
Zip : 60201-5303
Country : US
Telephone Number : 847-570-9359
Fax Number : 847-570-9510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 07/08/2007

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Directions to “ DR. ROGER PEYTON PLOTKIN M.D.” Practice Location

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