TERRY ROTH
NPI 1215919816
Psychiatry & Neurology - Neurology in Rockford, IL

Q: What is Terry Roth's NPI number?

The NPI number for Terry Roth is 1215919816. It was assigned to this individual provider in the NPPES registry on November 18, 2005.

Q: What is Terry Roth's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Q: When was this NPI record last updated?

The NPPES record for Terry Roth was last updated on May 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 18, 2005

4920 EAST STATE ST, ROCKFORD, IL 61108(815) 226-1906(815) 226-8474 Get Directions Write a Review

NPPES record last updated: May 22, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Terry Roth NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TERRY ROTH (NPI 1215919816) is an individual neurology provider in Rockford, Illinois, licensed in Illinois (36059503) and active in the NPI registry since November 2005.

NPPES Registry Identity

NPI1215919816

Entity TypeIndividualMale

Primary Taxonomy2084N0400X

Provider Legal NameTERRY ROTH

Location Address4920 EAST STATE STRockford, IL 61108

Mailing Address4920 East State StRockford, IL 61108 · (815) 226-1906 · Fax (815) 226-8474

Phone(815) 226-1906

Fax(815) 226-8474

Sole ProprietorNo

Enumeration DateNovember 18, 2005

Last NPPES UpdateMay 22, 2008

✔ NPI 1215919816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians

Taxonomy Code2084N0400X

License✔ Licensed in IL · 36059503

Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

4920 EAST STATE ST, Rockford, IL 61108

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Other Identifiers 6

Medicaid036059503IL

Other0010100550IL · Bcbs

Other009771IL · Health Alliance

Medicare ID-Type Unspecified629800IL

Medicare UPIND14087

Other791133579IL · Retired Railroad

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Terry Roth's NPI number?

The NPI number for Terry Roth is 1215919816. It was assigned to this individual provider in the NPPES registry on November 18, 2005.

Where is Terry Roth located?

Terry Roth practices at 4920 East State St, Rockford, IL 61108. The listed phone number is (815) 226-1906.

What is Terry Roth's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

When was this NPI record last updated?

The NPPES record for Terry Roth was last updated on May 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.