Active NPI
Clifford W. Rot, PH.D.
- Clinical Psychologist
- Park Ridge, IL
National Provider Identifier
1457351082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-003583
- Practice address
- 2604 Dempster St
Suite 510
Park Ridge, IL 60068-8412 - Phone
- (847) 910-0182
- NPI assigned
- Jul 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071-003583 | IL | Primary |
Addresses
Primary practice location
2604 Dempster St
Suite 510
Park Ridge, IL 60068-8412
Mailing address
1005 Meadow LN
Elgin, IL 60123-1429
Phone (847) 910-0182
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1673232 | Other | IL | BC/BS PPO PROVIDER |
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-003583 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212278400000",
"number": "1457351082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 MEADOW LN",
"city": "ELGIN",
"state": "IL",
"postal_code": "601231429",
"telephone_number": "847-910-0182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2604 DEMPSTER ST",
"address_2": "SUITE 510",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600688412",
"telephone_number": "847-910-0182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROT",
"first_name": "CLIFFORD",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-26",
"last_updated": "2008-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-003583",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PPO PROVIDER",
"identifier": "1673232",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.