Provider Demographics
NPI:1760596886
Name:ROCK, MICHAEL H (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:ROCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1165 N CLARK ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2702
Mailing Address - Country:US
Mailing Address - Phone:312-809-6500
Mailing Address - Fax:312-809-6501
Practice Address - Street 1:6145 N NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2127
Practice Address - Country:US
Practice Address - Phone:312-809-6500
Practice Address - Fax:312-809-6501
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036078236207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL364054341OtherCOMMERCIAL INS.GROUP#
IL0001620300OtherBLUECROSS BLUESHILD OF IL
IL036078236 1Medicaid
ILF3116Medicare UPIN
ILL50795Medicare PIN