Provider Demographics
NPI:1952551947
Name:YOUSSEFI, ROD ROOZ (MD)
Entity Type:Individual
Prefix:DR
First Name:ROD
Middle Name:ROOZ
Last Name:YOUSSEFI
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 1:3660 N LAKE SHORE DR
Mailing Address - Street 2:#2613
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-5300
Mailing Address - Country:US
Mailing Address - Phone:310-266-6735
Mailing Address - Fax:
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:F5-704
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:310-266-6735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125052324207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology