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General NPI Number Information
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NPI Number | 1609850981
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Entity Type | Individual
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Provider Name | MICHELLE PATRICIA ROSE MD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 3275 N ARLINGTON HEIGHTS RD STE 409
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-7709
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Country | US
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Telephone | 224-857-8000
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Fax | 224-857-8001
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Provider Business Mailing Address
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Address Line | 3275 N ARLINGTON HEIGHTS RD STE 409
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-7709
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Country | US
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Telephone | 224-857-8000
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Fax | 224-857-8001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036087669
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License Number State | IL
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