Individual provider Active NPI

Carole Ann Rosanova, MD

  • Forensic Psychiatry Physician
  • Kildeer, IL
National Provider Identifier
1184848145
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
Practice address
21627 Andover Rd
Kildeer, IL 60047-8609
Phone
(847) 501-9666
NPI assigned
Apr 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X IL Primary

Addresses

Primary practice location

21627 Andover Rd
Kildeer, IL 60047-8609

Mailing address

21627 Andover Rd
Kildeer, IL 60047-8609
Phone (847) 501-9666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160406000054 IL Order and Referring Only - PsychiatryPractitioner - Psychiatry 2769780873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036047073ILMDForensic Psychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184848145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21627 ANDOVER RD",
            "city": "KILDEER",
            "state": "IL",
            "postal_code": "600478609",
            "telephone_number": "847-501-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21627 ANDOVER RD",
            "city": "KILDEER",
            "state": "IL",
            "postal_code": "600478609",
            "telephone_number": "847-501-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSANOVA",
        "first_name": "CAROLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kildeer, IL

Sources for this page

Verify at the official NPI Registry.