Healthcare Provider Details

I. General information

NPI: 1376163436
Provider Name (Legal Business Name): ROSARIO BARTOLOMEO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2020
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 ILLINI DR STE 201
SILVIS IL
61282-1893
US

IV. Provider business mailing address

4440 W 95TH ST RM 131
OAK LAWN IL
60453-2600
US

V. Phone/Fax

Practice location:
  • Phone: 563-421-4244
  • Fax:
Mailing address:
  • Phone: 708-684-5674
  • Fax: 708-684-2500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberDO-55457
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number036165016
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: