Rosaura Licea (NPI# 1548299225, PAC ID# 4789580721) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1548299225 |
| PAC ID by PECOS | 4789580721 |
| Professional Enrollment ID | I20040105000094 |
| Full Name | Rosaura Licea |
| Address |
5712 W 35th St Cicero IL 60804-4222 |
| Gender | F |
| Credential | MD |
| Medical School | CHICAGO COLLEGE OF MEDICINE AND SURGERY |
| Graduation Year | 1993 |
| Primary Specialty | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140054 | MACNEAL HOSPITAL |
| 140276 | LOYOLA UNIVERSITY MEDICAL CENTER |
| 140242 | CENTRAL DUPAGE HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5712 W 35th St, Cicero, IL 60804-4222 |
| Street Address |
5712 W 35TH ST |
| City | CICERO |
| State | IL |
| Zip | 60804-4222 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patricia Broderick | Clinical Social Worker | Catholic Charities of The Archdiocese of Chicago | 1400 S Austin Blvd, Cicero, IL 60804-1003 |
| Juanita Uribe | Clinical Social Worker | Catholic Charities of The Archdiocese of Chicago | 1400 S Austin Blvd, Cicero, IL 60804-1003 |
| Adriana Carmona | Clinical Social Worker | Catholic Charities of The Archdiocese of Chicago | 1400 S Austin Blvd, Cicero, IL 60804-1003 |
| Maeve A Raphelson | Clinical Social Worker | Catholic Charities of The Archdiocese of Chicago | 1400 S Austin Blvd, Cicero, IL 60804-1003 |
| Linda J Volino | Clinical Social Worker | Catholic Charities of The Archdiocese of Chicago | 1400 S Austin Blvd, Cicero, IL 60804-1003 |
| Elizabeth J Kelly | Nurse Practitioner | Mount Sinai Community Foundation | 1611 S Cicero Ave, Cicero, IL 60804-1520 |
| Kevin George Hendrix | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 1621 S Cicero Ave, Cicero, IL 60804-1520 |
| Tessa Qualkinbush | Family Medicine | Mount Sinai Community Foundation | 1611 S Cicero Ave, Cicero, IL 60804-1520 |
| Siu Yeung | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 1621 S Cicero Ave, Cicero, IL 60804-1520 |
| Richard E Pugh | Physical Therapy | Accelerated Rehabilitation Centers Ltd | 1621 S Cicero Ave, Cicero, IL 60804-1520 |
| Find all physicians in zip 60804 | |||
| City | CICERO |
| Zip Code | 60804 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | CICERO + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.