Mary Eileen Roth, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209034461 Issued in IL

Practice address

344 W Hubbard St
Chicago, IL 60654-4407

Phone

(312) 222-2570

NPI assigned

Jul 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Eileen Gerardo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1164094843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 N RACINE AVE APT 1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143404",
            "telephone_number": "804-658-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 W HUBBARD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544407",
            "telephone_number": "312-222-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MARY",
        "middle_name": "EILEEN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209034461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "GERARDO",
            "middle_name": "EILEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeffrey David Roth, MD
• Jessica Roth
• Julianna L Roth, MD
• Lana Roth, LCSW
• Larry Roth
• Rachel Roth, LCSW
• Robert Killion Roth
• Stephanie L Roth, LCPC
• Steven Roth, MD
• Tamara Roth, CADC

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.