Provider Demographics
NPI:1053052027
Name:SOBOTA, ROSEMARY JOAN (APRN, CNP)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:JOAN
Last Name:SOBOTA
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 RANDALL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4219
Mailing Address - Country:US
Mailing Address - Phone:630-232-0202
Mailing Address - Fax:630-232-9784
Practice Address - Street 1:302 RANDALL RD STE 105
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4219
Practice Address - Country:US
Practice Address - Phone:630-232-0202
Practice Address - Fax:630-232-9784
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209024876363L00000X
IL209.024876363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily