Provider Demographics
NPI:1255571725
Name:DELAGARZA, ROSONNE (DN)
Entity type:Individual
Prefix:DR
First Name:ROSONNE
Middle Name:
Last Name:DELAGARZA
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 GAMBLE DR
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2404
Mailing Address - Country:US
Mailing Address - Phone:630-241-4541
Mailing Address - Fax:
Practice Address - Street 1:564 GAMBLE DR
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-2404
Practice Address - Country:US
Practice Address - Phone:630-241-4541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181000171172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath