Provider Demographics
NPI:1790903219
Name:ROTATORI, ANTHONY FRANCIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:FRANCIS
Last Name:ROTATORI
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 1:1339 FAIRFIELD CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2967
Mailing Address - Country:US
Mailing Address - Phone:630-305-9750
Mailing Address - Fax:
Practice Address - Street 1:1339 FAIRFIELD CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-2967
Practice Address - Country:US
Practice Address - Phone:630-305-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical