Healthcare Provider Details

I. General information

NPI: 1417847740
Provider Name (Legal Business Name): VENUS ROSENDO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15230 EL CAMENO REAL DR APT 2E
ORLAND PARK IL
60462-3001
US

IV. Provider business mailing address

15230 EL CAMENO REAL DR APT 2E
ORLAND PARK IL
60462-3001
US

V. Phone/Fax

Practice location:
  • Phone: 708-990-2000
  • Fax: 708-990-2000
Mailing address:
  • Phone: 708-990-2000
  • Fax: 708-990-2000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209032502
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041439224
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: