Roger Haab, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-079768 Issued in IL

Practice address

1850 Gateway Dr
Sycamore, IL 60178-3192

Phone

(815) 758-8671

NPI assigned

Aug 5, 2006

Last updated

Aug 3, 2010By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dekalb Clinic Chartered

  • Internal Medicine Physician
  • Sycamore, IL
  • NPI 1447277140
  Authorized official Same address or phone
• Northern Illinois Imaging Specialists LLC

  • Nuclear Medicine Physician
  • Dekalb, IL
  • NPI 1487680765
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1386653517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-758-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783192",
            "telephone_number": "815-758-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAB",
        "first_name": "ROGER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-079768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036079768",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "008454",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grand Victorian of Sycamore, LLC
• Greater Family Health (Center for Family Health)
• Amanda Grogan
• Stephen Guziec, LCPC
• An Ha
• Danielle Hall, APRN, FNP-C
• Cindy Halstead
• Brooke Hannan, OTR/L
• Harold Hansen, LMT
• Stephanie J Harsh, M.O.T.R.L

• Internal Medicine Physician in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.

Verify at the official NPI Registry.