Organization
ROSANOVA EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ANTHONY ROSANOVA M.D. (PRESIDENT)
(847) 882-8680
Entity
Organization
Contact information
Practice address
1555 N BARRINGTON RD, DOB 1, SUITE 330, HOFFMAN ESTATES, IL 60169-4033
(847) 882-8680
(877) 776-1220
Mailing address
5872 N MILWAUKEE AVE, CHICAGO, IL 60646-5425
(773) 594-0000
(773) 594-0017
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036067273
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634901
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/15/2006
Last updated
06/16/2021
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