Healthcare Provider Details

I. General information

NPI: 1104216993
Provider Name (Legal Business Name): TAMARA L ROGERS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMARA L ROGERS MSN, APN, FNP-BC

II. Dates (important events)

Enumeration Date: 01/31/2015
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N OAK ST
HINSDALE IL
60521-3829
US

IV. Provider business mailing address

120 N OAK ST
HINSDALE IL
60521-3829
US

V. Phone/Fax

Practice location:
  • Phone: 630-856-7440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209012518
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: