Healthcare Provider Details

I. General information

NPI: 1871035121
Provider Name (Legal Business Name): ROSINA HANNILORA VICTOR RN, APN,CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2016
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W CENTRAL RD STE 6200
ARLINGTON HEIGHTS IL
60005-2378
US

IV. Provider business mailing address

880 W CENTRAL RD STE 6200
ARLINGTON HEIGHTS IL
60005-2378
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0730
  • Fax: 847-618-0799
Mailing address:
  • Phone: 847-618-0730
  • Fax: 847-618-0799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number209014902
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209014901
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: