Individual
ISIS AZIZA ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPM, MA, CLC
Contact information
Practice address
217 W WILLIAMS ST, DANVILLE, IL 61832-4534
(447) 305-0166
Mailing address
904 N BROADWAY AVE APT 219, URBANA, IL 61801-1760
(217) 419-5514
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
176B00000X
Midwife
Primary
295.001295
IL
374J00000X
Doula
—
IL
374J00000X
Doula
Primary
—
—
Other
Enumeration date
03/18/2021
Last updated
05/29/2026
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