Basic Information
| Provider Information | |||||||||
| NPI: | 1841216488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSNER | ||||||||
| FirstName: | NEAL | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | CHICAGO HTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604111748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087560100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 333 DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | CHICAGO HTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604111748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087560100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 02/07/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | IL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | P00006275/CK6883 | 01 | IL | RAILROAD MEDICARE PIN | OTHER | L022428 | 01 | IL | CHAMPUS | OTHER | P00006274/CK6882 | 01 | IL | RAILROAD PIN | OTHER | 4673170001 | 01 | IL | DMERC GROUP | OTHER | 062839 | 01 | IL | HEALTH ALLIANCE NUMBER | OTHER |