Provider Demographics
NPI:1770633430
Name:ROTHKE, STEVEN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:ROTHKE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SKOKIE BOULEVARD
Mailing Address - Street 2:SUITE 602
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-7914
Mailing Address - Country:US
Mailing Address - Phone:847-480-5744
Mailing Address - Fax:847-480-5755
Practice Address - Street 1:450 SKOKIE BOULEVARD
Practice Address - Street 2:SUITE 602
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-7914
Practice Address - Country:US
Practice Address - Phone:847-480-5744
Practice Address - Fax:847-480-5755
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103G00000X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic