Healthcare Provider Details

I. General information

NPI: 1114727625
Provider Name (Legal Business Name): ROSA ROMO APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5999 NEW WILKE RD
ROLLING MEADOWS IL
60008-4506
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0800
  • Fax: 847-228-1062
Mailing address:
  • Phone: 847-982-3175
  • Fax: 847-733-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209032233
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: