Healthcare Provider Details

I. General information

NPI: 1134458474
Provider Name (Legal Business Name): REBECCA ANN ROSENTHAL D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA ANN MURPHY D.C.

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 01/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 SUMMIT STREET
GALENA IL
61036
US

IV. Provider business mailing address

202 SUMMIT STREET
GALENA IL
61036
US

V. Phone/Fax

Practice location:
  • Phone: 815-776-0595
  • Fax: 815-776-0595
Mailing address:
  • Phone: 815-776-0595
  • Fax: 815-776-0595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number007243
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4551012
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038011927
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: