Provider Demographics
NPI:1295351583
Name:CAMARENA, ROSA ELVA (FNP)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:ELVA
Last Name:CAMARENA
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 1:1275 E BELVIDERE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2080
Mailing Address - Country:US
Mailing Address - Phone:847-548-2528
Mailing Address - Fax:847-548-2152
Practice Address - Street 1:1275 E BELVIDERE RD STE 110
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2080
Practice Address - Country:US
Practice Address - Phone:847-548-2528
Practice Address - Fax:847-548-2152
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily