Individual
JEFFREY KENNETH ROSENWINKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27655 ILLINOIS ROUTE 120, LAKEMOOR, IL 60051
(815) 458-1500
(815) 458-1501
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01084381A
IN
207Q00000X
Family Medicine Physician
Primary
036171070
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300040921
—
IN
Enumeration date
06/05/2017
Last updated
08/02/2024
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