Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 036137828 | IL |
NPI | 1467666081 |
---|---|
Provider Name | Dr. Connie Jean Rossini |
First Address | Chicago, IL 60612 |
Second Address | Chicago, IL 60612-3841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 10/08/2018 |