Daniel Roche I

Individual provider Active NPI Specialist · Chicago Heights, IL

NPI 1861677833 · NPPES record last updated Jan 8, 2008

Key facts

NPI
1861677833
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
Practice address
242 W. Maple Drive
Chicago Heights, IL 60411-2070
Phone
(708) 754-2592
NPI assigned
Jan 8, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Yes

Addresses

Primary practice location

242 W. Maple Drive
Chicago Heights, IL 60411-2070

Mailing address

242 W Maple Dr
Chicago Heights, IL 60411-2070

Other providers in Chicago Heights, IL

All providers in Chicago Heights, IL · Specialist in Illinois

Sources for this page

Verify at the official NPI Registry.