Jason Roth, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

125060683 Issued in IL

Practice address

1725 W Harrison St Ste 340
Chicago, IL 60612-3852

Phone

(312) 664-6715

Fax

(312) 563-0165

NPI assigned

Feb 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• University Head and Neck Associates, SC

  • Otolaryngology Physician
  • Downers Grove, IL
  • NPI 1598755456
  NPD (past)

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1104199868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N COLUMBUS DR APT 4912",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606015232",
            "telephone_number": "630-574-8222",
            "fax_number": "630-574-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 340",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123852",
            "telephone_number": "312-664-6715",
            "fax_number": "312-563-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-10",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "125060683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget Kathleen Roth
• Elliot Roth, MD
• Hannah Fay Roth, MD
• Heidi Roth, PT
• James Gerard Roth, O.D.
• Jay Roth, LCSW
• Jeffrey David Roth, MD
• Jessica Roth
• Julianna L Roth, MD
• Lana Roth, LCSW

• Otolaryngology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.