Individual provider · Type 1 NPI

Mary Eileen Roth, FNP-BC

Family Nurse Practitioner · Chicago, IL

NPI number 1164094843 Active

Practice location

344 W Hubbard St
Chicago, IL 60654-4407

Mailing address

2446 N Racine Ave Apt 1F
Chicago, IL 60614-3404

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X209034461 (IL)

Family Nurse Practitioner: Definition to come...

12 other providers at this address

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About NPI 1164094843

Mary Eileen Roth, FNP-BC's National Provider Identifier is 1164094843, issued on Jul 13, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Chicago, IL. The record was last updated on Aug 27, 2026.