Provider Demographics
NPI:1366553448
Name:OFFICES OF RICHARD S. ROCK M D
Entity type:Organization
Organization Name:OFFICES OF RICHARD S. ROCK M D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ROCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-295-0584
Mailing Address - Street 1:2101 WAUKEGAN RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-1836
Mailing Address - Country:US
Mailing Address - Phone:847-295-0584
Mailing Address - Fax:847-295-0637
Practice Address - Street 1:2101 WAUKEGAN RD
Practice Address - Street 2:SUITE 301
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1836
Practice Address - Country:US
Practice Address - Phone:847-295-0584
Practice Address - Fax:847-295-0637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036059624207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty