Provider Demographics
NPI:1073580122
Name:ROHRSCHEIB, SIDNEY P (MD)
Entity Type:Individual
Prefix:PROF
First Name:SIDNEY
Middle Name:P
Last Name:ROHRSCHEIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 ILLINI DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IL
Mailing Address - Zip Code:61727-9444
Mailing Address - Country:US
Mailing Address - Phone:217-935-7037
Mailing Address - Fax:217-935-7047
Practice Address - Street 1:803 ILLINI DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IL
Practice Address - Zip Code:61727-9444
Practice Address - Country:US
Practice Address - Phone:217-935-7037
Practice Address - Fax:217-935-7047
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.064607208600000X
IL036090160208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036090160Medicaid
IL202641Medicare ID - Type Unspecified