Individual
JOSE ALBERTO ROSALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1726 W 18TH ST, CHICAGO, IL 60608-3994
(312) 733-7454
Mailing address
3105 QUINCY LN, AURORA, IL 60504-6816
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032116
IL
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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