Active NPI
Mario A Roldan, M.D
- Obstetrics & Gynecology Physician
- Chicago, IL
National Provider Identifier
1841237658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 36050636
- Practice address
- 1044 N Mozart St
Chicago, IL 60622-2789 - Phone
- (888) 676-5326
- Fax
- (773) 276-3179
- NPI assigned
- Jun 1, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 36050636 | IL | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | 01058156A | IN |
Addresses
Primary practice location
1044 N Mozart St
Chicago, IL 60622-2789
Mailing address
4314 W Pratt Ave
Lincolnwood, IL 60712-3535
Phone (847) 679-0494
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231227002415 | IL | Order and Referring Only - Obstetrics/Gynecology | 4981823028 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36050636 | IL | MD | Obstetrics & Gynecology Physician |
| 01058156A | IN | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1841237658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4314 W PRATT AVE",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607123535",
"telephone_number": "847-679-0494",
"fax_number": "773-276-3179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1044 N MOZART ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606222789",
"telephone_number": "888-676-5326",
"fax_number": "773-276-3179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLDAN",
"first_name": "MARIO",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "36050636",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IN",
"license": "01058156A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.