Healthcare Provider Details

I. General information

NPI: 1992378046
Provider Name (Legal Business Name): ROSITA LANA RAMROOP AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1S 280 SUMMIT AVE #A1
OAKBROOK TERRACE IL
60681-1702
US

IV. Provider business mailing address

1725 W HARRISON ST STE 207
CHICAGO IL
60612-3988
US

V. Phone/Fax

Practice location:
  • Phone: 773-320-7307
  • Fax:
Mailing address:
  • Phone: 312-942-5861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209017460
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209.017460
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number209017460
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: