Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Roosevelt Road Clinic MD SC

Organization Internal Medicine Physician · NPI 1952765232

Roosevelt Road Clinic MD SC is an Internal Medicine Physician in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016

Practice location Address checks out

3600 W Roosevelt Rd
Chicago, IL 60624-4225
Phone: (773) 638-6761
Fax: (773) 638-6984
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 036056560 (IL)

Record details

NPI number1952765232
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Subarna Pradhan — President · (773) 638-6761
NPI enumeratedApril 12, 2016
Last updated in NPPESApril 12, 2016
Mailing address3600 W Roosevelt Rd, Chicago, IL 60624-4225

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