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NPI Code Detail

MEDICARE: TASIA ROGERS

MEDICARE: TASIA ROGERS
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
1363L00000XNurse Practitioner209.033963IL

General Provider Information

NPI Number : 1255295838
Entity Type Code : Individual
Provider Name (Legal Business Name) : TASIA ROGERS
Provider Business Mailing Address
First Line : 10111 S VAN VLISSINGEN RD
Second Line :
City : CHICAGO
State : IL
Zip : 60617-5638
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7733 W GRAND AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-1820
Country : US
Telephone Number : 708-452-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ TASIA ROGERS ” Practice Location

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