Organization Active NPI

Mary Ann Rosanova-Kaper, M.D., S.C.

  • Clinic/Center
  • Barrington, IL
National Provider Identifier
1962704965
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
36.042248 Issued in IL
Legal business name
MARY ANN ROSANOVA-KAPER, M.D., S.C.
Practice address
330 E Main St
Suite 1W
Barrington, IL 60010-3203
Phone
(847) 381-4300
Fax
(847) 381-4350
NPI assigned
Nov 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Authorized official

Name
Dr. Mary Ann Rosanova-Kaper, M.D.
Title
Owner
Phone
(847) 381-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 36.042248 IL Primary

Addresses

Primary practice location

330 E Main St
Suite 1W
Barrington, IL 60010-3203

Mailing address

330 East Main Street
Suite 1W
Barrington, IL 60010
Phone (847) 381-4300

Other identifiers 1

IdentifierTypeStateIssuer
036042248MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110110000760 IL Part B Supplier - Clinic/Group Practice 6103015912 Receives reassigned benefits from 1 practitioner
Practice locations: Barrington, IL

National Provider Directory

National Provider Directory

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": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1962704965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 EAST MAIN STREET",
            "address_2": "SUITE 1W",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "60010",
            "telephone_number": "847-381-4300",
            "fax_number": "847-381-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 E MAIN ST",
            "address_2": "SUITE 1W",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600103203",
            "telephone_number": "847-381-4300",
            "fax_number": "847-381-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN ROSANOVA-KAPER, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "ROSANOVA-KAPER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-381-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "36.042248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036042248",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barrington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.