KATELYN ELIZABETH DEROSA (NPI# 1346732021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346732021 |
| Entity Type | Individual |
| Full Name | KATELYN ELIZABETH DEROSA |
| Credential | PA-C |
| Practice Address |
1875 Dempster St Ste 280 Park Ridge IL 60068-1157 |
| Mailing Address |
1425 Niess Ct Glendale Heights IL 60139-2708 |
| Practice Telephone | 8473189071 |
| Mailing Telephone | 6302674187 |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2018-05-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085.006570 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1875 DEMPSTER ST STE 280 |
| City | PARK RIDGE |
| State | IL |
| Zip Code | 60068-1157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109011 | Samantha Pinto Consol | Physician Assistant | 1875 Dempster St Ste 280, Park Ridge, IL 60068-1157 | 2020-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010720 | Caitlin Marie Kompanowski | Dentist | 412 W. Talcott, Park Ridge, IL 60068 | 2020-07-08 |
| 1972142198 | Center for Authentic Living, Inc. | Counselor | 120 Main Street Suite 200, Park Ridge, IL 60068 | 2020-01-06 |
| 1306312152 | Maryann Almores Devilla | Physical Medicine & Rehabilitation | Sunrise Assisted Living, 1725 Ballard Road, Park Ridge, IL 60068 | 2018-10-19 |
| 1053808857 | Landon Ginsberg | Student in an Organized Health Care Education/Training Program | 1775 Ballard, Park Ridge, IL 60068 | 2018-04-17 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
| 1205367448 | Courtney Heim | Psychiatry & Neurology | 1875 W.dempster Street - Park Side Professional Center, Ste 470, Park Ridge, IL 60068 | 2017-03-21 |
| 1720521362 | Alexander Mylonas | Psychologist | 1400 Renaissance Dr Ste 401, Park Ridge, IL 60068 | 2016-11-30 |
| 1376090878 | Rebecca Rajasekhar | Audiologist | 1030 W. Higgins Rd., Audiology Room 6, Park Ridge, IL 60068 | 2016-09-01 |
| 1164818449 | Mohammad Taha Mustaf Taha Mustafa Sheikh | Student in an Organized Health Care Education/Training Program | 1550 North Northwest Highway Suite 107, L.m. Prasad, Md, Sc, Park Ridge, IL 60068 | 2015-04-13 |
| 1518397918 | Megan Roberts | Speech-Language Pathologist | 2240 Campus Dr., Evanston, IL 60068 | 2013-11-21 |
| Find all providers in zip 60068 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912554932 | Kelly Cunningham | Physician Assistant | 1550 N Northwest Hwy Ste 220, Park Ridge, IL 60068-1459 | 2019-08-23 |
| 1639437684 | Premier Wellcare, Inc. | Physician Assistant | 400 W. Higgins Rd., Park Ridge, IL 60068 | 2012-04-27 |
| 1508020983 | Erin Patrick Olsen | Physician Assistant | 1550 N. Northwest Hwy., Suite 211, Park Ridge, IL 60068 | 2008-07-15 |
| 1477699254 | Brittany Ann Scurto | Physician Assistant | 1550 N Northwest Hwy Ste 300, Park Ridge, IL 60068-1460 | 2007-01-29 |
| 1679109011 | Samantha Pinto Consol | Physician Assistant | 1875 Dempster St Ste 280, Park Ridge, IL 60068-1157 | 2020-03-17 |
| 1760031462 | Christine Moran | Physician Assistant | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2019-09-05 |
| 1861040248 | Jessica Lemek | Physician Assistant | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2019-08-29 |
| 1497317119 | Molly Kenney | Physician Assistant | 1875 Dempster St Ste 265, Park Ridge, IL 60068-1126 | 2019-07-02 |
| 1427520253 | Amy Mitrano | Physician Assistant | 1875 Dempster St Ste 265, Park Ridge, IL 60068-1126 | 2018-12-18 |
| 1104398965 | Molly Baker | Physician Assistant | 1875 Dempster St Ste 265, Park Ridge, IL 60068-1126 | 2018-12-18 |
| Find all providers in PARK RIDGE | ||||
| City | PARK RIDGE |
| Zip Code | 60068 |
Please comment or provide details below to improve the information on KATELYN ELIZABETH DEROSA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.