MEDICARE: MS. ROSALIE CYRIER APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	41-244380	IL
2	363LW0102X	Women's Health Nurse Practitioner	209-001485	IL

General Provider Information

NPI Number	:	1891917001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROSALIE CYRIER APN

Provider Business Mailing Address
First Line	:	2861 N CLARK ST
Second Line	:	2ND FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60657-5207
Country	:	US
Telephone Number	:	312-744-4094
Fax Number	:	312-744-2573

Provider Business Practice Location Address
First Line	:	2861 N CLARK ST
Second Line	:	2ND FL.
City	:	CHICAGO
State	:	IL
Zip	:	60657-5207
Country	:	US
Telephone Number	:	312-744-4094
Fax Number	:	312-744-2573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	06/22/2010

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