Individual
MRS. COLLEEN ELIZABETH ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(847) 322-3562
Mailing address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.013738
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.013738
209.013738
IL
Enumeration date
05/10/2016
Last updated
05/10/2016
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