Individual
KATHLEEN T. ROGOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1051 W US ROUTE 6, SUITE 100, MORRIS, IL 60450-3349
(815) 942-4875
(815) 942-5046
Mailing address
1051 W US ROUTE 6, SUITE 100, MORRIS, IL 60450-3349
(815) 942-4875
(815) 942-5046
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085-002737
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085-002737
STATE LICENSE
IL
Enumeration date
11/20/2006
Last updated
07/13/2009
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