Provider Demographics
NPI:1588614218
Name:LOCKE-ROSENBERG, FRANCES (CNM)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:LOCKE-ROSENBERG
Suffix:
Gender:M
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W FULTON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1259
Mailing Address - Country:US
Mailing Address - Phone:312-526-2000
Mailing Address - Fax:
Practice Address - Street 1:1555 W HOWARD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-1707
Practice Address - Country:US
Practice Address - Phone:773-764-7146
Practice Address - Fax:773-764-3774
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-005147367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209-005147OtherAPN LICENSE
IL041-307266OtherRN LICENSE
367830Medicare PIN