Provider Demographics
NPI:1831369800
Name:DIGESTIVE HEALTH ASSOCIATES, P.C.
Entity type:Organization
Organization Name:DIGESTIVE HEALTH ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:815-725-5950
Mailing Address - Street 1:1100 HOUBOLT RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-9063
Mailing Address - Country:US
Mailing Address - Phone:815-725-5950
Mailing Address - Fax:815-725-3666
Practice Address - Street 1:1715 DIVISION ST
Practice Address - Street 2:SUITE A
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-3100
Practice Address - Country:US
Practice Address - Phone:815-942-1550
Practice Address - Fax:815-942-8419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty