Active NPI
Bryon A Rosner, MD
- Obstetrics & Gynecology Physician
- Hazel Crest, IL
National Provider Identifier
1336219203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036-078555
- Practice address
- 17850 S Kedzie
Suite 3100
Hazel Crest, IL 60429-2086 - Phone
- (708) 798-2400
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 036078555 | IL | |
| Obstetrics & Gynecology Physician | 207V00000X | 036-078555 | IL | Primary |
Addresses
Primary practice location
17850 S Kedzie
Suite 3100
Hazel Crest, IL 60429-2086
Mailing address
17850 S Kedzie
Suite 3100
Hazel Crest, IL 60429-2086
Phone (708) 798-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036078555 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-078555 | IL | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475798400000",
"number": "1336219203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17850 S KEDZIE",
"address_2": "SUITE 3100",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604292086",
"telephone_number": "708-798-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17850 S KEDZIE",
"address_2": "SUITE 3100",
"city": "HAZEL CREST",
"state": "IL",
"postal_code": "604292086",
"telephone_number": "708-798-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSNER",
"first_name": "BRYON",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2016-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": "036078555",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036-078555",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036078555",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hazel Crest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.