Individual provider Active NPI

Brian Rotskoff

  • Allergy Physician
  • Chicago, IL
National Provider Identifier
1285662304
Registry record updated Jun 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
036-102370 Issued in IL
Practice address
4801 W Peterson Ave
Suite 306
Chicago, IL 60646-5713
Phone
(773) 877-3500
Fax
(888) 228-2622
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 036-102370 IL Primary

Addresses

Primary practice location

4801 W Peterson Ave
Suite 306
Chicago, IL 60646-5713

Mailing address

4801 W Peterson Ave
Suite 306
Chicago, IL 60646-5713
Phone (773) 877-3500

Other names 1

  • Dr. Brian Rotskoff Professional name

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
I20040119000099 IL Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 7810898277

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-102370ILMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alexian Brothers Medical Group Specialty Care PastSince Jun 15, 2010 Accepting new patients
Advanced Allergy & Asthma Associates SC PastSince May 18, 2013 Accepting new patients
Skokie Emergency Services, LLC Past Accepting new patients
Advanced Allergists LTD. Allergy Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276128000000",
    "number": "1285662304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE",
            "address_2": "SUITE 306",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465713",
            "telephone_number": "773-877-3500",
            "fax_number": "888-228-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W PETERSON AVE",
            "address_2": "SUITE 306",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465713",
            "telephone_number": "773-877-3500",
            "fax_number": "888-228-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTSKOFF",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": "036-102370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIAN",
            "last_name": "ROTSKOFF",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.