Provider Demographics
NPI:1013940238
Name:ESPINOZA, ROSEMARY (MD)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 HALIGUS RD STE 120
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9526
Mailing Address - Country:US
Mailing Address - Phone:815-356-2323
Mailing Address - Fax:847-802-7201
Practice Address - Street 1:10350 HALIGUS RD STE 120
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9526
Practice Address - Country:US
Practice Address - Phone:815-356-2323
Practice Address - Fax:847-802-7201
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-100786207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036100786Medicaid
IL036100786Medicaid
IL0727500001Medicare NSC
ILL80434Medicare ID - Type Unspecified
H23445Medicare UPIN