Active NPI
Mary K Rosenow, MD, PHD
- Surgery Physician
- Tunnel Hill, IL
National Provider Identifier
1023080702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- IL036060221
- Practice address
- 1135 Possum Rd
Tunnel Hill, IL 62972-3138 - Phone
- (270) 994-6969
- NPI assigned
- Feb 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | IL036060221 | IL | Primary |
Addresses
Primary practice location
1135 Possum Rd
Tunnel Hill, IL 62972-3138
Mailing address
1135 Possum Rd
Tunnel Hill, IL 62972-3138
Phone (270) 994-6969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IL036060221 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson County Surgical Associates | Surgery | Past | Accepting new patients |
| Little Company of Mary Affiliated Services Inc | Surgery | Past | Accepting new patients |
| Southern Illinois Medical Services, NFP | Past | Accepting new patients | |
| Odonoghue & Rosenow, MDSC | Surgery | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Internal Medicine Physician
- Evergreen Park, IL
- NPI 1588617260
Surgery
-
- Surgery Physician
- Evergreen Park, IL
- NPI 1083816565
-
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427155200000",
"number": "1023080702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 POSSUM RD",
"city": "TUNNEL HILL",
"state": "IL",
"postal_code": "629723138",
"telephone_number": "270-994-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1135 POSSUM RD",
"city": "TUNNEL HILL",
"state": "IL",
"postal_code": "629723138",
"telephone_number": "270-994-6969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENOW",
"first_name": "MARY",
"middle_name": "K",
"credential": "MD, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-06",
"last_updated": "2015-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "IL036060221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tunnel Hill, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.