Provider Demographics
NPI:1407997794
Name:F.A.ROSALES, M.D., S.C.
Entity Type:Organization
Organization Name:F.A.ROSALES, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:ROSALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-896-4050
Mailing Address - Street 1:143 S LINCOLN AVE STE N
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-4290
Mailing Address - Country:US
Mailing Address - Phone:630-896-4050
Mailing Address - Fax:630-896-4084
Practice Address - Street 1:143 S LINCOLN AVE STE N
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-4290
Practice Address - Country:US
Practice Address - Phone:630-896-4050
Practice Address - Fax:630-896-4084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-060-287207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4520111OtherBCBS
IL036060287Medicaid
IL036060287Medicaid
IL940200Medicare PIN