Matilda M Rosanwo in Crystal Lake - Family Medicine
Matilda M Rosanwo - NPI 1871570978
Matilda M Rosanwo is a Family Medicine in Crystal Lake, Illinois. Matilda M Rosanwo practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Matilda M Rosanwo is 1871570978. The last update date is 2018-10-22.
Matilda M Rosanwo's current location address is 360 Station Dr, Crystal Lake, Illinois. You can contact this provider via phone number 8153386600 and fax number 8154558044. The mailing address for Matilda M Rosanwo is 360 Station Dr, Crystal Lake, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Name | Matilda M Rosanwo |
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Address | 360 Station Dr, Crystal Lake, Illinois |
Phone Number | 8153386600 |
Fax Number | 8154558044 |
Sole Proprietor | N |
Credentials | MD |
NPI Number Detail
NPI Number | 1871570978 |
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Provider Enumeration Date | 2005-12-29 |
Last Updated Date | 2018-10-22 |
Provider Mailing Address Detail
Address | 360 Station Dr |
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City | Crystal Lake |
State | Illinois (IL) |
Post Code | 600147978 |
Phone Number | 8153386600 |
Fax Number | 8154558044 |
Provider's Primary Taxonomy Detail
Speciality | Family Medicine |
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Taxonomy | 207Q00000X |
Licence No | 36104686 |
Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
36104686 | IL | STATE LICENSE | |
P00424928 | IL | RR MEDICARE | |
361046863 | IL | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Matilda M Rosanwo?
The Matilda M Rosanwo has been issued the NPI (National Provider Identifier) 1871570978 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Matilda M Rosanwo?
The Matilda M Rosanwo is physically situated at 360 Station Dr, in the city of Crystal Lake, state of IL, with the postal code 600147978.
What is Matilda M Rosanwo's specialized field of practice, and what is the corresponding taxonomy classification code?
The Matilda M Rosanwo's area of specialization is Family Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Q00000X.
On what date did the Matilda M Rosanwo receive its 1871570978 assignment from the Centers for Medicare & Medicaid Services?
The Matilda M Rosanwo was assigned its 1871570978 by the Centers for Medicare & Medicaid Services on 2005-12-29.
As of what date was the information regarding Matilda M Rosanwo, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Matilda M Rosanwo, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2018-10-22.