Provider Demographics
NPI:1154988715
Name:ROSENAU, NORA (OTR)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:ROSENAU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:IMPERL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-5154
Mailing Address - Country:US
Mailing Address - Phone:414-364-1504
Mailing Address - Fax:
Practice Address - Street 1:41 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-5154
Practice Address - Country:US
Practice Address - Phone:847-707-6744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-20
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6466-26225X00000X
IL056.013588225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist