Individual
KATELYN ELIZABETH DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1875 DEMPSTER ST STE 640, PARK RIDGE, IL 60068
(847) 297-6380
(847) 297-0589
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006570
IL
Other
Enumeration date
05/30/2018
Last updated
07/05/2023
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