Individual
TINA M ROZENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 N MAPLE ST, EFFINGHAM, IL 62401-2003
(217) 342-4151
(217) 347-0108
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036094764
IL
208000000X
Pediatrics Physician
Primary
036094764
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094764
—
IL
01
—
054508
HEALTH ALLIANCE #
IL
01
—
2523659
BC/BS #
IL
01
—
370012295
RAILROAD MEDICARE/PALMETTO GBA
IL
01
—
386900
HEALTHLINK #
IL
Enumeration date
06/28/2006
Last updated
05/20/2020
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