Individual
ED ALLEN ROSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
333 MADISON ST, JOLIET, IL 60435-8200
(815) 725-7133
Mailing address
6655 PINE LAKE DR, TINLEY PARK, IL 60477-4934
(708) 271-7738
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209013519
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
08/15/2015
Last updated
11/09/2015
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