Provider Demographics
NPI:1689920316
Name:ROCKEY, PAUL H (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:H
Last Name:ROCKEY
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 1:515 N STATE ST
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-4854
Mailing Address - Country:US
Mailing Address - Phone:312-755-7473
Mailing Address - Fax:312-755-7498
Practice Address - Street 1:515 N STATE ST
Practice Address - Street 2:SUITE 2000
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-4854
Practice Address - Country:US
Practice Address - Phone:312-755-7473
Practice Address - Fax:312-755-7498
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036082329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036082329OtherSTATE OF ILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION