Individual
SY H ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.
Contact information
Practice address
9933 LAWLER AVE, #409, SKOKIE, IL 60077-3703
(847) 410-2751
Mailing address
3549 GROVE ST, EVANSTON, IL 60203-1819
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
213000062
IL
224P00000X
Prosthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
99322112
BLUE CROSS
IL
Enumeration date
05/01/2006
Last updated
02/12/2013
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