Provider Demographics
NPI:1275512964
Name:ROSENBERG, AARON G (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:G
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR
Mailing Address - Street 2:#240
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1611 W HARRISON ST
Practice Address - Street 2:STE 400
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-243-4244
Practice Address - Fax:312-942-1517
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060220207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036060220 4Medicaid
IL1633878OtherBCBS GROUP ID#
IL207067OtherMEDICARE PTAN LOCALITY 16
ILDA4902OtherRR MEDICARE PTAN #
ILDA4902OtherRR MEDICARE PTAN#
IL4029001OtherAETNA ID#
IL207073OtherMEDICARE PTAN LOCALITY 15
ILP00071112OtherRR MEDICARE ID#
ILB74136Medicare UPIN
ILP00071112OtherRR MEDICARE ID#
ILK01338Medicare PIN