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General NPI Number Information
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NPI Number | 1902904618
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Entity Type | Individual
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Provider Name | BELEN DE LA ROSA MS, APN, BC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5TH AVE & ROOSEVELT ROAD BUILDING 228, ROOM 3067
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City | HINES
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State | IL
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Zip | 60141
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Country | US
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Telephone | 708-202-4569
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Fax |
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Provider Business Mailing Address
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Address Line | 128 60TH ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-2037
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Country | US
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Telephone | 630-852-2786
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Fax |
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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 | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State | IL
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