Provider Demographics
NPI:1851832018
Name:NORTHERN ROSE CAREGIVERS
Entity Type:Organization
Organization Name:NORTHERN ROSE CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TREGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-543-4319
Mailing Address - Street 1:15 COMMERCE DR STE 117
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7807
Mailing Address - Country:US
Mailing Address - Phone:847-543-4319
Mailing Address - Fax:847-543-6883
Practice Address - Street 1:1015 N CORPORATE CIR
Practice Address - Street 2:SUITE D
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7813
Practice Address - Country:US
Practice Address - Phone:847-543-4319
Practice Address - Fax:847-543-6883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000961253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care