Provider Demographics
NPI:1093865339
Name:DR PAUL K. ROSENBERG, LTD
Entity Type:Organization
Organization Name:DR PAUL K. ROSENBERG, LTD
Other - Org Name:FEMALE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DELFAVERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-980-3366
Mailing Address - Street 1:471 W ARMY TRAIL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2673
Mailing Address - Country:US
Mailing Address - Phone:630-980-3366
Mailing Address - Fax:630-980-3686
Practice Address - Street 1:471 W ARMY TRAIL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2673
Practice Address - Country:US
Practice Address - Phone:630-980-3366
Practice Address - Fax:630-980-3686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060521207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL722470Medicare PIN
ILD15407Medicare UPIN