Provider Demographics
NPI:1720368434
Name:TANG, ROSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:
Last Name:TANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 TALLGRASS DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-5083
Mailing Address - Country:US
Mailing Address - Phone:847-964-6571
Mailing Address - Fax:
Practice Address - Street 1:1417 LAKE COOK RD
Practice Address - Street 2:MSL 444
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5238
Practice Address - Country:US
Practice Address - Phone:847-964-6571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.039183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist