Mark Roome, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036085356 Issued in IL

Practice address

19550 Governors Hwy
Ste 2500
Flossmoor, IL 60422-2125

Phone

(708) 799-7600

Fax

(708) 799-8848

NPI assigned

Mar 26, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: mroome1271671@epic00.shdirect.org

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.

• Mukund R Shah MD PLC

  • Pediatrics Physician
  • Saint Joseph, MI
  • NPI 1649440231
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346368909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR",
            "address_2": "STE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275993",
            "telephone_number": "773-834-1061",
            "fax_number": "773-834-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 GOVERNORS HWY",
            "address_2": "STE 2500",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222125",
            "telephone_number": "708-799-7600",
            "fax_number": "708-799-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOME",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036085356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085356",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Snead LTD
• Courtney Robinson
• Lashanda Robinson, BSN
• Nicole Rogers, LMT
• Judith Ann Romaine, LCSW
• Root & Resonance PLLC
• Davida Rosenbloom, LCSW
• Nathan S Rosendale, PT, DPT
• Gracemary Rosenthal, LCSW
• Jacqueline Rochelle Ross, PHD

• Pediatrics Physician in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.