Individual
STACY A ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 W CENTRAL RD, ARLINGTON HEIGHTS, IL 60005-2349
(847) 618-3040
(847) 618-3049
Mailing address
800 W CENTRAL RD, ARLINGTON HEIGHTS, IL 60005-2349
(847) 618-3040
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-003858
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085003858
STATE LICENSE
IL
Enumeration date
09/29/2010
Last updated
01/23/2023
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