ROQUE-PONTON MEDICAL GROUP S.C. NPI 1457570459

NPI Information

ROQUE-PONTON MEDICAL GROUP, S.C. is a child and adolescent psychiatry psychiatry neurology in Chicago, IL. The provider is 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. ROQUE-PONTON MEDICAL GROUP, S.C. NPI is 1457570459. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2740 W FOSTER AVE
SUITE 313
CHICAGO, IL
ZIP 60625-500
Phone: (773) 271-4455
Fax: (773) 271-4540

The provider's authorized official is David Lopez Roque .
The authorized official title is President and has the following contact phone number (773) 271-3344.

The CLIA number assigned to this NPI record is 14D0976943 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/25/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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