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NPI Code Detail

MEDICARE: DR. THERESA ANNE ROWE D.O.

MEDICARE: DR. THERESA ANNE ROWE D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician036132914IL

General Provider Information

NPI Number : 1184747248
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THERESA ANNE ROWE D.O.
Provider Business Mailing Address
First Line : 675 N SAINT CLAIR ST STE 18-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5929
Country : US
Telephone Number : 312-695-4525
Fax Number :
Provider Business Practice Location Address
First Line : 675 N SAINT CLAIR ST STE 18-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5929
Country : US
Telephone Number : 312-695-4525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2007
Last Update Date : 08/19/2015

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