| Provider / Organization | NPI | Date Certified |
|---|---|---|
| VANESSA SORAYA ROSE | 1730716325 | 2023-12-06 |
Vanessa Soraya Rose is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1730716325. Registration indicates Vanessa Soraya Rose is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Family Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Vanessa Soraya Rose MD |
| Practice Office Address | 635 N DEARBORN ST STE 100 CHICAGO, IL US |
| Practice Office Telephone | 3126942127 |
| Practice Office Fax | 3126942129 |
| Mailing Address | 635 N DEARBORN ST STE 100 CHICAGO, IL 606544618 US |
| Business Telephone | 3126942127 |
| Business Fax | 3126942129 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1475 E Belvidere Rd Unit 385 | Grayslake, IL 600302026 | 8475357157 / 3126940655 |
| 1000 N Westmoreland Rd | Lake Forest, IL 600451658 | 8472345600 |
| 251 E Huron St | Chicago, IL 606112908 | 3129262000 |
| Code | Practice | License No State |
|---|---|---|
| 207Q00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | 036167258
IL |
| 207Q00000X | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | 125076426
IL |