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ROQUE-PONTON MEDICAL GROUP, S.C.
NPI 1457570459
Psychiatry & Neurology - Child & Adolescent Psychiatry in Chicago, IL

Active since April 25, 2007CLIA 14D0976943 · Waiver
2740 W FOSTER AVE, SUITE 313, CHICAGO, IL 60625(773) 271-4455(773) 271-4540 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Roque-ponton Medical Group, S.c. NPPES

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

ROQUE-PONTON MEDICAL GROUP, S.C. (NPI 1457570459) is a healthcare organization registered as a child & adolescent psychiatry in Chicago, Illinois and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through August 15, 2028 and lists David Lopez Roque, President, as its authorized official.

NPPES Registry Identity

NPI1457570459
Entity TypeOrganization
Primary Taxonomy2084P0804X
Legal Business NameROQUE-PONTON MEDICAL GROUP, S.C.
Location Address2740 W FOSTER AVE, SUITE 313Chicago, IL 60625-3500
Mailing Address3861 W Pratt AveLincolnwood, IL 60712-2544 · (773) 271-3344 · Fax (773) 271-4540
Phone(773) 271-4455
Fax(773) 271-4540
Organization SubpartNo
Authorized OfficialDavid Lopez RoquePresident · (773) 271-3344
Enumeration DateApril 25, 2007
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1457570459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedGeneral PracticeTaxonomy 208D00000X
2740 W FOSTER AVE, Chicago, IL 60625
Open in Google Maps ↗

Other Identifiers 2

Other38340020WI · Family Practice
Other5348AK · Family Practice

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roque-ponton Medical Group, S.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Roque-Ponton Medical Group, S.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

David Roque, MD
Family Practice
NPI 1770502940
2740 W FOSTER SUITE 313
Chicago, IL 60625
(773) 271-3344
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0976943

Roque-Ponton Medical Group Sc · Chicago, IL
Active · expires Aug 15, 2028
CLIA Number14D0976943
Laboratory TypePhysician Office
Certificate Effective DateAugust 16, 2026
Certificate Expiration DateAugust 15, 2028
Laboratory DirectorDavid L. Roque
Laboratory Phone(773) 271-3344
Laboratory LocationRoque-Ponton Medical Group Sc2740 W Foster, Suite 313, Chicago, IL 60625
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Roque-Ponton Medical Group, S.C.'s NPI number?

The NPI number for Roque-Ponton Medical Group, S.C. is 1457570459. It was assigned to this organization in the NPPES registry on April 25, 2007.

Where is Roque-Ponton Medical Group, S.C. located?

Roque-Ponton Medical Group, S.C. is located at 2740 W Foster Ave Suite 313, Chicago, IL 60625. The listed phone number is (773) 271-4455.

What is Roque-Ponton Medical Group, S.C.'s specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Roque-Ponton Medical Group, S.C. enrolled in Medicare?

Yes. Roque-Ponton Medical Group, S.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Roque-Ponton Medical Group, S.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Roque-Ponton Medical Group, S.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Roque-Ponton Medical Group, S.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0976943) is associated with this NPI, valid through August 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Roque-Ponton Medical Group, S.C. was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.