Provider Demographics
NPI:1265514343
Name:SCHAUMBERG, ROSE MARY (FNP)
Entity type:Individual
Prefix:MS
First Name:ROSE
Middle Name:MARY
Last Name:SCHAUMBERG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1379 N 1789TH ST
Mailing Address - Street 2:
Mailing Address - City:STREATOR
Mailing Address - State:IL
Mailing Address - Zip Code:61364-9355
Mailing Address - Country:US
Mailing Address - Phone:815-673-1537
Mailing Address - Fax:
Practice Address - Street 1:2970 CHARTRES STREET
Practice Address - Street 2:
Practice Address - City:LASALLE
Practice Address - State:IL
Practice Address - Zip Code:61301
Practice Address - Country:US
Practice Address - Phone:815-223-9678
Practice Address - Fax:815-223-9683
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily