Organization Active NPI

Rosanova Eyecare LLC

  • Ophthalmology Physician
  • Hoffman Estates, IL
National Provider Identifier
1265476725
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036067273 Issued in IL
Legal business name
ROSANOVA EYECARE LLC
Practice address
1555 N Barrington Rd
Dob 1, Suite 330
Hoffman Estates, IL 60169-4033
Phone
(847) 882-8680
Fax
(877) 776-1220
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Authorized official

Name
Dr. Mark Anthony Rosanova, M.D.
Title
President
Phone
(847) 882-8680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 036067273 IL Primary

Addresses

Primary practice location

1555 N Barrington Rd
Dob 1, Suite 330
Hoffman Estates, IL 60169-4033

Mailing address

5872 N Milwaukee Ave
Chicago, IL 60646-5425
Phone (773) 594-0000

Other identifiers 1

IdentifierTypeStateIssuer
01634901OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050208000979 IL Part B Supplier - Clinic/Group Practice 2860443769 Receives reassigned benefits from 1 practitioner
Practice locations: Barrington, IL; Hoffman Estates, IL

National Provider Directory

National Provider Directory

Locations

101 Lions Dr
Ste 120
Barrington, IL 60010
Phone (773) 594-0000

1555 N Barrington Rd
Ste 330
Hoffman Estates, IL 60169
Phone (773) 594-0000

1555 N Barrington Rd
Ste 330
Hoffman Estates, IL 60169
Phone (847) 882-8680

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1265476725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5872 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606465425",
            "telephone_number": "773-594-0000",
            "fax_number": "773-594-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 N BARRINGTON RD",
            "address_2": "DOB 1, SUITE 330",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601694033",
            "telephone_number": "847-882-8680",
            "fax_number": "877-776-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSANOVA EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "ROSANOVA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-882-8680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036067273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01634901",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.