Individual provider Active NPI

Howard I Roth, M.D.

  • Vascular & Interventional Radiology Physician
  • Kankakee, IL
National Provider Identifier
1043381239
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
036079163 Issued in IL
Practice address
350 N Wall St
Kankakee, IL 60901-2901
Phone
(815) 933-1671
NPI assigned
Nov 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036079163 IL
Vascular & Interventional Radiology Physician 2085R0204X 036079163 IL Primary

Addresses

Primary practice location

350 N Wall St
Kankakee, IL 60901-2901

Mailing address

111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272

Other identifiers 2

IdentifierTypeStateIssuer
036079163MedicaidIL
4615054OtherILBCBS ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050517000965 IL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 1456263011 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Northwestern University Feinberg Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians
Health Service Systems, IncGroup PAC ID 2264408699, 63 clinicians
Cira Michigan PCGroup PAC ID 7113355264, 89 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1000 W Harlem Ave
Monmouth, IL 61462-1007
Phone (309) 734-1400

1051 W S St
Kewanee, IL 61443-8354
Phone (309) 852-7500

1100 E Norris Dr
Ottawa, IL 61350-1604
Phone (815) 433-3100

111 Spring St
Streator, IL 61364-3332
Phone (815) 673-2311

12701 W 143Rd St
Homer Glen, IL 60491-7715
Phone (708) 364-6337

1400 W Park St
Urbana, IL 61801-2334
Phone (309) 740-4272

1401 E 12TH St
Mendota, IL 61342-9216
Phone (815) 539-7461

1650 Midtown Rd
Peru, IL 61354-1200
Phone (815) 538-1351

1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9623
Phone (815) 727-4292

1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (815) 300-1100

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311

2200 Fort Jesse Rd
Suite 100
Normal, IL 61761-6286
Phone (309) 661-6280

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522

2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828

2658 N Hermitage Ave
Chicago, IL 60614-4130
Phone (906) 786-5707

2800 W 95TH St
Evergreen, IL 60805-2701
Phone (309) 740-4272

3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-1000

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

435 Maxine Dr
Morton, IL 61550-2498
Phone (309) 263-2424

500 W Romeo B Garrett Ave
Peoria, IL 61605-2301
Phone (309) 740-4272

5114 N Glen Park Place Rd
Peoria, IL 61614-4686
Phone (309) 683-2428

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 740-4272

530 Neglen Oak Ave
Peoria, IL 61636-0001
Phone (309) 655-2000

530 Park Ave E
Perry Memorial Hosp
Princeton, IL 61356-3901
Phone (815) 875-2811

603 S 13TH St
Suite E
Pekin, IL 61554-4935
Phone (309) 353-0214

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036079163ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Dec 6, 2025 Accepting new patients
Health Service Systems, Inc CurrentSince Jan 25, 2026 Accepting new patients
Riverside Health System CurrentSince Jan 11, 2023 Accepting new patients
Health Service Systems, Inc CurrentSince Jan 25, 2026 Accepting new patients
Cira Michigan PC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Riverside Health System Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Aug 20, 2025 Accepting new patients
Midwest Heart Specialists, LTD Vascular & Interventional Radiology Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Edward Cardiovascular Institute Past Accepting new patients
Edward Cardiovascular Institute Past Accepting new patients
Kankakee Radiology Associates, S.C. Past Accepting new patients

Locations

5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748

500 N Wall St
Ste 100
Kankakee, IL 60901
Phone (815) 933-2557

401 N Wall St
Ste 205
Kankakee, IL 60901
Phone (815) 932-2541

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

500 N Wall St
Ste C100
Kankakee, IL 60901
Phone (844) 404-4787

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144

530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054

114 W Stratford Dr
Ste E
Peoria, IL 61614
Phone (309) 740-4270

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1043381239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901",
            "telephone_number": "815-933-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "HOWARD",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036079163",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036079163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079163",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "4615054",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.