Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036134942 | IL |
N | 111NI0900X | Internist | 036134942 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036.134942 | IL |
Y | 207RI0011X | Interventional Cardiology | 036.134942 | IL |
NPI | 1083900989 |
---|---|
Provider Name | Dr. Jonathan Reuben Rosenberg |
First Address | Evanston, IL 60201-1779 |
Second Address | Evanston, IL 60201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 01/04/2021 |