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

Benjamin S Roth

Individual provider Physical Therapist · NPI 1124618046

Benjamin S Roth is a Physical Therapist in Private Practice in Le Roy, Illinois. Qualified in 2020, 6 years ago. Practices with Athletic and Therapeutic Institute of Bourbonnais, LLC, a 170-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2021

Practice location Address checks out

200 E Cedar St Ste 3
Le Roy, IL 61752-1903
Phone: (309) 962-3240
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1124618046
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 25, 2021
Last updated in NPPESJanuary 25, 2021
Certification dateJanuary 25, 2021
Mailing address790 Remington Blvd, Bolingbrook, IL 60440-4909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Athletic And Therapeutic Institute Of Bourbonnais, Llc — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Le Roy