Provider Demographics
NPI:1184848145
Name:ROSANOVA, CAROLE ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:ANN
Last Name:ROSANOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21627 ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:KILDEER
Mailing Address - State:IL
Mailing Address - Zip Code:60047-8609
Mailing Address - Country:US
Mailing Address - Phone:847-501-9666
Mailing Address - Fax:
Practice Address - Street 1:21627 ANDOVER RD
Practice Address - Street 2:
Practice Address - City:KILDEER
Practice Address - State:IL
Practice Address - Zip Code:60047-8609
Practice Address - Country:US
Practice Address - Phone:847-501-9666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry