Active NPI
Connor Roth, PHARMD, BCOP
- Oncology Pharmacist
- Olympia Fields, IL
National Provider Identifier
1962098889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oncology Pharmacist
- License
- 051.300423
- Practice address
- 3900 W 203Rd St
Olympia Fields, IL 60461-1183 - Phone
- (708) 855-7082
- NPI assigned
- Dec 15, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oncology Pharmacist | 1835X0200X | 051.300423 | IL | Primary |
Addresses
Primary practice location
3900 W 203Rd St
Olympia Fields, IL 60461-1183
Mailing address
3900 W 203Rd St
Olympia Fields, IL 60461-1183
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.300423 | IL | MD | Oncology Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1962098889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 W 203RD ST",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 W 203RD ST",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611183",
"telephone_number": "708-855-7082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "CONNOR",
"credential": "PHARMD, BCOP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-15",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "1835X0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Oncology",
"state": "IL",
"license": "051.300423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olympia Fields, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.