Provider Demographics
NPI:1538548276
Name:SANTOS, ROSANNA VALINO (APN NP-C)
Entity type:Individual
Prefix:
First Name:ROSANNA
Middle Name:VALINO
Last Name:SANTOS
Suffix:
Gender:F
Credentials:APN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 PISTAKEE PKWY
Mailing Address - Street 2:
Mailing Address - City:FOX LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60020-1921
Mailing Address - Country:US
Mailing Address - Phone:773-750-2273
Mailing Address - Fax:
Practice Address - Street 1:515 PISTAKEE PKWY
Practice Address - Street 2:
Practice Address - City:FOX LAKE
Practice Address - State:IL
Practice Address - Zip Code:60020-1921
Practice Address - Country:US
Practice Address - Phone:773-750-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily