Individual
MICHAEL ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201
(847) 570-2477
Mailing address
2650 RIDGE AVE, EVANSTON, IL 60201-1700
(847) 570-2477
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036.143765
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036143765
STATE LICENSE
IL
Enumeration date
03/31/2014
Last updated
05/22/2019
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