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Matilda M Rosanwo, MD
Family Medicine Physician in Crystal Lake, Illinois
NPI 1871570978

Matilda M Rosanwo is a Family Medicine Physician based in Crystal Lake, IL. Matilda M Rosanwo practices in Crystal Lake, IL and has the professional credentials of MD. The NPI Number for Matilda M Rosanwo is 1871570978 and holds a License No. 036104686 (Illinois).

The current practice location address for Matilda M Rosanwo is 360 Station Dr, Crystal Lake, IL and can be reached out via phone at 815-338-6600 and via fax at 815-455-8044.

Location: 360 Station Dr, Crystal Lake, IL, 60014-7978
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871570978
Provider Name
Matilda M Rosanwo
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
360 Station Dr, Crystal Lake, IL, 60014-7978
Phone Number
815-338-6600
Fax Number
815-455-8044
Provider Enumeration Date
12/29/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036104686 01 IL STATE LICENSE
P00424928 01 IL RR MEDICARE
0361046863 05 IL
institution
Provider Business Practice Location Address Details
Address
360 Station Dr
City
Crystal Lake
State
Illinois
Zip
60014
Phone Number
815-338-6600
Fax Number
815-455-8044
person
Provider Business Mailing Address Details
Address
360 Station Dr
City
Crystal Lake
State
Illinois
Zip
60014
Phone Number
815-338-6600
Fax Number
815-455-8044
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
036104686 (Illinois)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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