Provider Demographics
NPI:1093299851
Name:ROSA, RACHEL (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:ROSA
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:7411 LAKE ST STE 2110
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1886
Mailing Address - Country:US
Mailing Address - Phone:708-848-4662
Mailing Address - Fax:708-613-4319
Practice Address - Street 1:7411 LAKE ST STE 2110
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1886
Practice Address - Country:US
Practice Address - Phone:708-848-4662
Practice Address - Fax:708-613-4319
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2020-08-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant