Active NPI
Sam Kun Roh, MD
- Pathology Specialist/Technologist
- Freeport, IL
National Provider Identifier
1295749703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pathology Specialist/Technologist
- License
- 036056229
- Practice address
- 1045 W Stephenson St
Freeport, IL 61032-4864 - Phone
- (815) 599-6218
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pathology Specialist/Technologist | 246Q00000X | 036056229 | IL | Primary |
Addresses
Primary practice location
1045 W Stephenson St
Freeport, IL 61032-4864
Mailing address
1255 W Empire St
PO Box268
Freeport, IL 61032-6100
Phone (815) 599-7958
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freeport Regional Health Care Foundation | Past | Accepting new patients | |
| Freeport Memorial Hospital | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Health Educator
- Freeport, IL
- NPI 1326880386
-
- Family Medicine Physician
- Freeport, IL
- NPI 1457337016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264550400000",
"number": "1295749703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1255 W EMPIRE ST",
"address_2": "PO BOX268",
"city": "FREEPORT",
"state": "IL",
"postal_code": "610326100",
"telephone_number": "815-599-7958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 W STEPHENSON ST",
"city": "FREEPORT",
"state": "IL",
"postal_code": "610324864",
"telephone_number": "815-599-6218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROH",
"first_name": "SAM",
"middle_name": "KUN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2010-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "246Q00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology",
"state": "IL",
"license": "036056229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freeport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.