Derek Roydavis, PA-C
Physician Assistant · Park Ridge, IL
Practice location
1700 Luther Ln Ste 1170Park Ridge, IL 60068-1270
- Phone
- (844) 376-3876
NPI record
- NPI
- 1265102826
- Entity type
- Individual (Type 1)
- Enumeration date
- September 15, 2021
- Last updated
- March 9, 2022
- Certified
- March 9, 2022
- Sole proprietor
- Yes
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X |
1186126 | — |
| Medical Physician Assistant | 363AM0700X |
— | — |
| Surgical Physician Assistant | 363AS0400X |
— | — |
Mailing address
29373 Network PlChicago, IL 60673-1293
- Phone
- (478) 390-5900
Other practice locations (1)
- 41 Mesa Dr, Bethany, CT 06524-3093 · (203) 980-3234
About Derek Roydavis
Derek Roydavis, PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 1700 Luther Ln Ste 1170, Park Ridge, IL 60068-1270. The NPI number 1265102826 was assigned on September 15, 2021 and the record was last updated on March 9, 2022.
Derek Roydavis lists a license in the registry: #1186126 for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Derek Roydavis, PA-C?
The NPI number is 1265102826.
What is the phone number of Derek Roydavis?
The phone number listed for the practice location is (844) 376-3876.
Where is Derek Roydavis located?
1700 Luther Ln Ste 1170, Park Ridge, IL 60068-1270.
What is the taxonomy code for Derek Roydavis?
The primary taxonomy code is 363A00000X – Physician Assistant; 2 more listed above.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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