Provider Demographics
NPI:1841216488
Name:ROSNER, NEAL H (MD)
Entity Type:Individual
Prefix:
First Name:NEAL
Middle Name:H
Last Name:ROSNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-1748
Mailing Address - Country:US
Mailing Address - Phone:708-756-0100
Mailing Address - Fax:
Practice Address - Street 1:333 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:CHICAGO HTS
Practice Address - State:IL
Practice Address - Zip Code:60411-1748
Practice Address - Country:US
Practice Address - Phone:708-756-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00006275/CK6883OtherRAILROAD MEDICARE PIN
ILL022428OtherCHAMPUS
ILP00006274/CK6882OtherRAILROAD PIN
IL4673170001OtherDMERC GROUP
IL062839OtherHEALTH ALLIANCE NUMBER
IL062839OtherHEALTH ALLIANCE NUMBER
ILL022428OtherCHAMPUS
ILL95461Medicare PIN
IL203980Medicare PIN
ILC43916Medicare UPIN
ILL95462Medicare PIN
ILP00006275/CK6883OtherRAILROAD MEDICARE PIN