Provider Demographics
NPI:1093802738
Name:SCHECK, ROY S (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:S
Last Name:SCHECK
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 1:115 WEST ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143
Mailing Address - Country:US
Mailing Address - Phone:630-773-0333
Mailing Address - Fax:630-773-4452
Practice Address - Street 1:115 WEST ORCHARD ST
Practice Address - Street 2:
Practice Address - City:ITASCA
Practice Address - State:IL
Practice Address - Zip Code:60143
Practice Address - Country:US
Practice Address - Phone:630-773-0333
Practice Address - Fax:630-773-4452
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02201486OtherBLUE CROSS BLUE SHIELD
IL971280Medicare ID - Type Unspecified
IL02201486OtherBLUE CROSS BLUE SHIELD