MARK ANDREW ROTERT (NPI# 1326483280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326483280 |
| Entity Type | Individual |
| Full Name | MARK ANDREW ROTERT |
| Credential | NP |
| Practice Address |
420 N Il Route 31 Crystal Lake IL 60012 |
| Mailing Address |
420 N Il Route 31 Crystal Lake IL 60012-3709 |
| Practice Telephone | 8157882018 |
| Mailing Telephone | 8157882018 |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2019-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209019035 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
2013013779 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2330 E. Meyer Blvd, Suite T209, Kansas City, MO 64132 | 8162353932 | 8558014879 |
| 420 N Il Route 31, Crystal Lake, IL 60012 | 8157882018 |
| Street Address |
420 N IL ROUTE 31 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467485128 | Gordon D Husby | Physical Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2006-07-08 |
| 1134648389 | Ryan Miguel Colon | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-09-19 |
| 1497295125 | Alexander J Hembrey | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-02-28 |
| 1316486459 | Nicole M Trittschuh | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2017-02-22 |
| 1356883599 | Centegra Primary Care LLC | Family Medicine | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2016-11-04 |
| 1770954125 | Lisa Zemaitis | Physical Therapy Assistant | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2015-10-12 |
| 1336552199 | Nicole Ashley Fox | Physical Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2014-06-09 |
| 1497168355 | Heather Michelle Murnane | Occupational Therapist | 420 N Il Route 31, Crystal Lake, IL 60012-3711 | 2014-06-09 |
| 1528487436 | Michael Christopher Ciccotti | Orthopaedic Surgery | 420 N Il Route 31, Crystal Lake, IL 60012-3709 | 2014-04-08 |
| 1548519986 | Stephanie H Goede | Physician Assistant | 420 N Il Route 31, Crystal Lake, IL 60012 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033574629 | Joan M Ryan | Counselor | 610 N Route 31, Suite E, Crystal Lake, IL 60012 | 2015-12-23 |
| 1285972331 | Lauren Elyse Westerman | Physical Therapist | 1000 Brighton Ln, Crystal Lake, IL 60012 | 2013-01-24 |
| 1447537469 | Sean Gale | Pharmacist | 135 Carmella Dr, Crystal Lake, IL 60012 | 2011-11-04 |
| 1477836625 | Judy Meekyung Fakhouri | Pharmacist | 315 N. Route 31, Crystal Lake, IL 60012 | 2011-09-23 |
| 1730462136 | Leslie Dawn Weckerlin | Pharmacist | 315 N Route 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1639452188 | Laura Jean Galles | Pharmacist | 315 N. Routet 31, Crystal Lake, IL 60012 | 2011-09-21 |
| 1326320516 | Stacey Jean Knuth | Pharmacist | 315 North Route 31, Crystal Lake, IL 60012 | 2011-09-13 |
| 1356469803 | Donn Orien Humphries | Chiropractor | 690 N Route 31, Suite F, Crystal Lake, IL 60012 | 2007-03-26 |
| 1538204508 | Midwest Physical Therapy Ctr | Clinic/Center | 630 N Rt 31, Suite 103, Crystal Lake, IL 60012 | 2007-02-20 |
| 1356488415 | Charlotte Joy Parcels | Social Worker | 8600 Route 14, Suite 110, Crystal Lake, IL 60012 | 2007-01-30 |
| Find all providers in zip 60012 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861785032 | Sharon E. Larsen | Nurse Practitioner | 380 N Terra Cotta Rd Ste E, Crystal Lake, IL 60012-1809 | 2011-05-22 |
| 1467640193 | Kathleen Mccleskey-grimes | Nurse Practitioner | 1305 Randall Rd, Crystal Lake, IL 60014-8601 | 2007-10-09 |
| 1801351648 | Jennifer A Garrels | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014-7978 | 2019-02-06 |
| 1760956726 | Cardinalight Health, LLC | Nurse Practitioner | 380 N Terra Cotta Rd Ste E, Crystal Lake, IL 60012-1809 | 2019-01-13 |
| 1780157602 | Well-rooted Pediatrics LLC | Nurse Practitioner | 820 E Terra Cotta Ave Ste 132, Crystal Lake, IL 60014-3655 | 2019-01-03 |
| 1861987604 | Lisa M Trautman | Nurse Practitioner | 5911 Northwest Hwy Ste 207, Crystal Lake, IL 60014-8043 | 2018-06-25 |
| 1538600820 | Catherine Arend | Nurse Practitioner | 741 S Mchenry Ave, Suite G, Crystal Lake, IL 60014-7445 | 2017-03-20 |
| 1265972418 | Lauren K Mielke | Nurse Practitioner | 781 S Mchenry Ave, Crystal Lake, IL 60014-7444 | 2017-03-06 |
| 1639526015 | Rachelle Puno | Nurse Practitioner | 1305 Randall Rd, Crystal Lake, IL 60014 | 2016-05-16 |
| 1386099208 | Roseann C Iverson | Nurse Practitioner | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1725 | 2016-04-28 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60012 |
Please comment or provide details below to improve the information on MARK ANDREW ROTERT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.