Individual
CREA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 E MAIN ST, SALEM, IL 62881-2926
(618) 740-2240
(618) 740-2241
Mailing address
207 E MAIN ST, SALEM, IL 62881-2926
(618) 740-2240
(618) 740-2241
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.025104
IL
Other
Enumeration date
04/12/2022
Last updated
04/19/2026
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