Provider Demographics
NPI:1407825276
Name:ROSE, SARAH J (ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:ROSE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 W BELDEN AVE
Mailing Address - Street 2:#1B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-3377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:875 N MICHIGAN AVE
Practice Address - Street 2:SUITE 3300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1803
Practice Address - Country:US
Practice Address - Phone:312-751-3733
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist