Provider Demographics
NPI:1649762204
Name:ONE ROSE ENTERPRISES, INC
Entity Type:Organization
Organization Name:ONE ROSE ENTERPRISES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:224-639-8142
Mailing Address - Street 1:876 BLAZING STAR TRL
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-3305
Mailing Address - Country:US
Mailing Address - Phone:224-639-8142
Mailing Address - Fax:
Practice Address - Street 1:2114 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-1370
Practice Address - Country:US
Practice Address - Phone:224-678-9424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty