Jay Roth, LCSW

NPI 1477900090 · on the registry since 2016 · sole proprietor

Practice

Address: 200 E 115th St
Chicago, IL 60628
Phone: (312) 747-2456
Organisation at this address: Community Triage Center
Roseland Outpatient Clinic
Chicago Dept. Of Public Health
Chicago Department Of Public Health
Chicago Department Of Public Health
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2016-05-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois