Provider Demographics
NPI:1285006866
Name:ROZA, ABIGAIL (CO)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:ROZA
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10719 160TH ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5541
Mailing Address - Country:US
Mailing Address - Phone:708-226-3300
Mailing Address - Fax:708-226-3500
Practice Address - Street 1:10719 160TH ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5541
Practice Address - Country:US
Practice Address - Phone:708-226-3300
Practice Address - Fax:708-226-3500
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist